RN CASE MANAGER (Full-time)

Description

Position Summary

The Case Manager assesses, plans, implements, coordinates, monitors and evaluates options to facilitate the continuum of care. The Case Manager provides a full range of case management services in collaboration with a multidisciplinary team. The Case Manager educates staff regarding effective allocation of the hospital’s resources while encouraging provision of high-quality patient care and is cognizant of regulations and policies of all review organizations relating to billing of the fiscal intermediaries.

Primary Responsibilities

1. Manage interactions with patients, families, physicians, payors and other health care providers to meet designated clinical, operational and financial outcomes for aggregate patient populations. 

2. Assist physicians, patients, families, staff and other health care providers in providing care for patient populations that is appropriate, effective, and cost efficient. 

3. Attend and actively participate in all departmental and interdepartmental meetings relative to Case Management, Social Services and Utilization review functions.

4. Documents Case Management plans in a clear and concise manner

5. Educate physicians and staff regarding appropriate level of care / utilization issues. 

6. Maintains current knowledge of Case Management, Social Services, Utilization and Nursing issues through continuing education

7. Acquires professional certification in area of Case Management within 2 years of hire

8. Participates in professional activities in order to continue professional development.

9. Will be required to cross train for Utilization Review duties.

Competencies

1. Knowledge of CMS, DHH, TJC regulations and reporting mechanisms

2. Able to work with a diverse patient and staff population with knowledge and sensitivity to cultural and spiritual influences impacting patient care

3. Knowledge of state and federal programs and community resources that provide medical care and financial support to individuals

4. Knowledge of basic computer skills

5. Deductive reasoning and communication skills

6. Teaching skills

7. Ability to read, write, speak, understand and communicate effectively in English

8. Ability to use appropriate discretion in handling confidential material and information

Supervisory Responsibility

None.

Requirements

Required Education and Experience

1. Current RN license.

2. Graduate of accredited school of Nursing.

3. Minimum of 5 years clinical experience.

Preferred Education and Experience

1. Previous Case Management experience.