Nursing Jobs in Downtown, MD

Nurse Case Manager

University of Maryland Medical System Glen Burnie, MD

Job Requirements General Summary Under supervision of the Case Management Leadership, will manage and oversee the comprehensive assessment, planning, implementation, monitoring, and overall evaluation of individual patient needs. A Case Manager assists in identifying appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the patient and the reimbursement source. A Case Manager will provide care management and coordination of care for patients across various diseases. A Case Manager will focus on achieving patient wellness and autonomy through advocacy, communication, education, identification of service resources and service facilitation. Overall, the Case Manager will promote direct communication with the patient, and appropriate service personnel, in order to optimize outcomes. Principal Responsibilities And Tasks The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified. Demonstrate critical thinking skills when utilizing the nursing process, based on research, evidence-based outcomes and Standards of Practice to meet patient’s health care needs. Gathers and analyzes specific criteria and guidelines to track inpatient admissions in and out-of-network, ED, readmission and high cost utilization of members associated with UMQCN/UMMS/UMBMC/UMBWMG providers. Create population-based management strategies and processes (based on a solid understanding of care management, including disease management and preventive care) that help patients manage their healthcare needs and foster care quality, cost-effectiveness, and patient engagement. Identify patients who may benefit from telephonic outreach or coordination of care; initiate the care-management processes in a quality focused, cost-effective manner across the continuum of care. Assists the Primary Care Physician to ensure the client's medical needs are met in the most efficient, cost- effective manner. Reach out to patients assigned by his or her supervisor to assess their most urgent needs, appraise the situation, and listen to the patients’ concerns Establish collaborative partnerships with patients to assist them in examining patterns of health care needs, decisions, lifestyle choices, and utilization of resources that affect their health. Advocate, educate and coach patients, the family and/or caregiver about treatment options, community resources, and psycho-social concerns in order to set goals and help the client develop self-care skills and independence appropriate to their age and developmental level. Implement Case Management interventions with the goal to optimize the patient’s health status Facilitate communication and coordination between members of the health care delivery team, involving the client in the decision-making process in order to minimize fragmentation in services. Document appropriately in patient medical records and/or care management application Coordinates community resources with emphasis on medical, behavioral and social services. Applies case management standards and maintains HIPAA standards and confidentiality of protected health information. Reports critical incidents and information regarding quality of care issues. Tracks, evaluates, and provides oversight for transitions of care, synchronizing “warm handoffs” between the clinic and hospitals, emergency departments or care facilities. Facilitates and ensures the sharing of information across people, functions, and sites. Work collaboratively with physicians and clinical and administrative leadership to design and implement case/disease-management protocols Manages active cases based on case intensity and acuity, per departmental standards. Specialty Case Manager caseloads may vary. Recognizes/understands responsibility of this key role and the responsibility this position demands in direct support of high quality patient care delivery regardless of assignment. This will be measured by the accountability/initiative taken in the performance of daily duties and assignments as itemized in major accountabilities section of job description. Establish collaborative partnerships with patients to assist them in examining patterns of health care needs, decisions, lifestyle choices, and utilization of resources that affect their health. Be attentive to detail to maintain accurate and timely data exchanges among all entities involved in the patients’ care Consult with other external agencies to provide support services and resources Communicate effectively with patients, physicians, and their staff on a regular basis. Delegates and oversees the care management of lower-risk patients as well as routine chronic disease population management tasks to assigned caregivers. Participates in monthly chart audits. Performs special projects as assigned. Ensures compliance with all state and federal regulations and guidelines in day-to-day activities. Demonstrates leadership, mentorship and teamwork within dedicated care teams including clinicians, chronic disease care coordinators, medical assistants, pharmacists, social workers and others Performs other duties as assigned. Work Experience Education and Experience Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required; BSN preferred. 3 to 5 years of care coordination experience and/or experience working in an outpatient ambulatory setting Experience with educating patients and patient goal setting (essential) Case Management Certification (preferred) Experience in a manage care information environment (preferred) Preferred experience would include knowledge of quality improvement processes (LEAN or PDSA); practice re-design work such as patient centered medical home and Joint Commission and National Committee for Quality Assurance (NCQA) accreditations. Knowledge, Skills And Abilities Knowledge and experience with managing and overseeing the comprehensive assessment, planning, implementation and overall evaluation of individual patient needs Proficient analytical, organization, and problem-solving skills to identify opportunities, to implement efficient work processes as it relates to case management Proficient documentation skills to maintain client records Ability to work effectively in a stressful work environment and handle confidential issues with integrity and discretion Critical thinking skills to analyze and solve problems Strong problem management strategies and issue resolution skills Excellent interpersonal, verbal, and written communication skills Strong organization skills, detail oriented, and knowledgeable Ability to work independently and effectively in a fast pace environment. Ability to work productively in a stressful environment and effectively handle multiple projects and changing priorities. Ability to effectively present information and respond to questions from families, members, providers, and clients, as well as the ability to relate effectively to upper management Ability to work independently, handle multiple assignments, establish priorities, and demonstrate high level time management skills Understands benefit/payer systems and reimbursement structures for patients. Strong clinical knowledge of broad range of medical practice settings and healthcare delivery systems Thorough and solid knowledge of health care and managed care delivery systems. This includes standards of medical practice, insurance benefits structure, and the utilization and case management process. Knowledge of state and federal laws and resources Proficiency in Microsoft Office including Outlook, Word, Excel and PowerPoint; knowledge of or the ability to learn care management/EMRsoftware (e.g., Epic) and other software in order to perform job duties

RN

Part-time

3 days ago

Clinical Nurse II

University of Maryland Medical System Bel Air, MD

$39.35 - $54.05 / hour

Job Requirements General Summary This role is considered the minimum role for all nurses who have greater than 12 months experience. Provides and coordinates independent care to patients within a clinical specialty as a fully effective and participative member of the multidisciplinary patient care services team. Utilizes the institution’s care delivery and professional practice models as the frame of reference for practicing as a professional nurse. Participates in activities to develop own practice, and to support group practice goals at the unit level. Is accountable to patient, family and team members for care provided and to the nurse manager for totality of work performance. Is accountable to hold to the Service Standards and to the Nursing Mission, Vision and Values. Responsibilities II. Principal Responsibilities and Tasks The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified. Clinical Practice Competency in care of unit specific patient population; independently practices with solid knowledge and clinical skills; engaged in advancing own practice. Serves as a clinical resource for others. Applies and integrates evidence into practice Functions effectively in roles specific to unit, such as arrest team for ICU, triage for ED, etc. Collaborates with interdisciplinary team to plan and coordinate care; independently advocating for patient/family needs Models practice consistent with unit operations to ensure safe, timely effective, efficient, equitable, patient centered care. Professional Development Engaged in advancing own practice. Responsible for maintaining competencies required for that patient care setting; focus on advancing own professional development. Attends unit based staff development independently. Demonstrates the ability to serve as a trained preceptor and coach’s new nurse and students. Contributes to developing/evaluating unit based orientation and other education activities. Contributes to nursing support personnel skills and development. Completes CE’s on an annual basis based on facility minimum requirements. Service/Quality Understands and contributes to unit-based outcomes associated with National Hospital Quality Measures (NDNQI), Nursing Sensitive Quality Indicators, and Facility Annual Operational Plan. Contributes to and endorses some or all elements of research/EBP/QI. Provides high quality, safe, patient centered care with focus on exceeding service expectations. Accountable for compliance with regulatory requirements and holds others accountable; participates in tracer activities when requested. Patient Safety Takes action to correct observed risks to patient safety. Reports adverse events and near misses to appropriate management authority. Implements policies, procedures, and guidelines consistently in the performance of assigned duties. Develops effective working relationships and maintains good communication with other team members. Identifies possible risks in processes, procedures, devices and communicates the same to those in charge. Participates in hospital, departmental and/or unit patient safety initiatives. Operations Demonstrates the ability to function in the charge nurse role. Participates in teambuilding efforts on their unit. Contributes to briefings/staff meetings regularly. Contributes and participates in unit, Nursing Division, and organizational governance structure. Participates in recruitment and retention activities at the unit level. Provides feedback in peer review as requested. Provides direct performance feedback at the direction of the nurse manager. Work Experience Qualifications Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required. More than 12 months nursing experience. Solid knowledge and clinical skills. Current AHA BLS certification required. Must meet all unit specific certification requirements: (PALS, ACLS, NRP) Benefits Part Time (7am-7:30pm) Pay Range: $39.35 - $54.05/hr. (depends on years of experience) Other Compensation (if applicable): Shift Differential Review the 2025-2026 UMMS Benefits Guide Like many employers, UMMS is being targeted by cybercriminals impersonating our recruiters and offering fake job opportunities. We will never ask for banking details, personal identification, or payment via email or text. If you suspect fraud, please contact us at careers@umms.edu.