Registered Nurse (Spanish proficient or fluent preferred) to perform the duties of community case management. The Baltimore City Cancer Program, (BCCP), is a breast, cervical, and colorectal screening, diagnosis and treatment program at University of MD Greenebaum Comprehensive Cancer Center. BCCP has been in existence for 20 ½ years, serving the uninsured/underinsured Baltimore city and surrounding metropolitan area community residents. BCCP has found to date, treated 156 cancers since 2001.

Under general supervision, provides utilization management, care coordination and discharge planning for an assigned patient case load. This role is patient focused, outcome-oriented, and based on general and specialty professional standards, and functions within a multi-disciplinary practice model; and other duties as assigned.

Community Nurse Case Management guidelines

• Oversees the client’s care through screening, diagnosis and, if indicated, treatment initiation.
• Identifies and acts to resolve or mitigate client barriers to screening, diagnosis and, if indicated, treatment initiation.
• Discusses medical management issues and recommendations with the medical case manager and network of primary care and specialty providers.
• Assures that appointments are scheduled in a timely manner and provides client education.
• Assures results have been received and recorded, and that the client has been notified and understands that results and recommendations.
• Assures linkage to funding source for further diagnostic and/or treatment services, if indicated.
• Data Entry of client’s results into the Maryland Department of Health databases.

Education/Experience

• Licensed as a Registered Nurse (RN) in the state of Maryland. Graduation from an accredited school is required
• Master's degree or certification as Case manager preferred
• Minimum of 5 years clinical nursing experience. Experience in acute care, as well as home health, ambulatory care and/or occupational health is preferred
• Knowledge of managed care, discharge planning, utilization and case management is required
• One year of experience in case management and knowledge of payer mechanisms an clinical utilization management is preferred

Essential Functions

1.Coordinates the integration of social services/case management functions into the patient care, discharge, and home planning process with other hospital departments, external service organizations, agencies, and healthcare facilities

2.Conducts concurrent medical record reviews using specific indicators and criteria as approved by medical staff, JCAHO, CMS, and other state agencies

3.Acts as patient advocate: investigates and reports adverse occurrences, and performs staff education related to resource utilization, discharge planning and psychosocial aspects of healthcare delivery

4.Promotes effective and efficient utilization of clinical resources

5.Assess patient care required throughout continuum of care diagnosis, procedures and DRG's