Care Management Nurse at The Nemours Foundation in Wilmington, Delaware

Posted in Health Care 30+ days ago.

This job brought to you by eQuest

Type: Full-Time





Job Description:

As one of the nation’s leading pediatric health care systems, Nemours is committed to providing all children with their best chance to grow up healthy. We offer integrated, family-centered care to more than 300,000 children each year in our pediatric hospitals, specialty clinics and primary care practices in Delaware, Florida, Maryland, New Jersey and Pennsylvania. Nemours strives to ensure a healthier tomorrow for all children – even those who may never enter our doors – through our world-changing research, education and advocacy efforts. At Nemours, our Associates help us deliver on the promise we make to every family we have the privilege of serving: to treat their child as if they were our own. 

The Care Management RN coordinates the utilization of pediatric healthcare resources, including transition planning, while facilitating the achievement of clinical, quality, financial and patient satisfaction goals across identified risk populations. Stratifies and/or validates patient level of risk during each transition process and interaction with the patient and family. Identifying and monitoring pediatric patient needs around care coordination utilizing the Care Link system. This position is embedded at the Christiana Care CareLink Center in Wilmington, with occasional need to travel.


  • Performs ongoing telephonic and/or embedded case management activities of assessment, problem identification, planning, implementation, coordination, monitoring and evaluation of pediatric patients.

  • Collaborates with patients, families and members of the multidisciplinary care team to develop a patient/family centered plan of care to meet identified patient care goals and outcomes.

  • Develop, implement, evaluate and revise case management care plans according to case management eligibility criteria, contractual guidelines and patient/family physical and psychological needs throughout the continuum of care.

  • Identify system issues that serve as barriers to care. Participate in development and implementation of strategies to remove barriers and promote resolution through coordination of a problem solving process.

  • Promote patient wellness and autonomy through advocacy, communication, education and identification and referral to community resources or other case/disease management programs.

  • Collaborate with healthcare professionals throughout the care continuum to facilitate the transition of the patient to the most appropriate level of care.

  • Demonstrate knowledge of utilization management and care coordination processes and current standards of care as a foundation for transition planning, complex case management and disease management activities.

  • Confers with Physician Advisor regarding complex cases requiring physician input regarding the treatment plan or physician to physician collaboration in the care of the pediatric patient.

  • Performs assigned work safely, adhering to established department safety rules and practices in a timely manner.  Acts as the liaison regarding care management programs, services, and activities by working with providers, payors, consultants, and other staff.

Qualifications:


  • Required: Licensed registered nurse (active and unrestricted in the State of Delaware). Must submit application for licensure in PA within 2 weeks of start date.

  • Preferred: Certified Case Manager (CCM), Case Manager, Certified (CMC) or Certified Professional in Health Care Quality (CPHCQ), expectation to obtain certification within 2 years of start

  • Preferred: Knowledge of models of case management and experience with how to transition care management functions from one model to another

  • Minimum of five (5) years pediatric nursing experience

  • Minimum of two (2) years of UM or Case Management experience

  • BSN preferred

Our dedication to professionals who are dedicated to children frequently earns Nemours a spot on the list of top workplaces in the communities we serve. Our Associates enjoy comprehensive benefits, including our unique “Bridge to a Healthy Future” pediatric health plan, an integrated wellness program, opportunities for professional growth, and much more. As an equal opportunity employer, Nemours focuses on the best-qualified applicants for our openings.