CASE MANAGER - RN

About the role

Maintains professional and technical knowledge by attending education workshops; reviewing professional publications; establishing personal networks; participating in professional societies.

Assures quality of care by adhering to therapeutic standards; measuring health outcomes against patient care goals and standards; making or recommending necessary adjustments; following system/hospital and nursing division's philosophies and standards of care set by state board of nursing, state nurse practice act, and other governing agency regulations.

Protects patients and employees by adhering to infection-control policies and protocols, medication administration and storage procedures, and controlled substance regulations.

Documents patient care services by charting in patient and department records.

Maintains continuity among nursing teams by documenting and communicating actions, irregularities, and continuing needs using Nurse Knowledge Exchange techniques.

Maintains patient confidence and protects operations by keeping information confidential.

Responsibilities

• Implements standard work, clinical protocols and patient care pathways.
• Manages transitions of care effectively as one of the critical components to reducing readmissions and poor health outcomes.
• Provides crisis management for clients; makes linkages for interventions as appropriate.
• Initiates care coordination strategies that are evidence-based and outcome focused.
• Ensures safe and effective transitions of care that help to promote positive health care outcomes for Independence Health System patients.
• Affirms care coordination that takes into account patients' values, needs, preferences and their choice to self-direct care.
• Promotes patient's independence by establishing patient care goals; teaching patient/family to understand condition, medications, and self-care skills; answering questions.
• Maintains a cooperative relationship among health care teams by communicating information; responding to requests; building rapport; participating in team continuous quality improvement and problem-solving methods.
• Contributes to team effort by accomplishing related results as needed.
• Facilitates the flow of care to expedite appropriate discharge and prevent readmissions.
• Assumes the leadership role in achieving outcomes and making the health system work for the patient.
• Bridges access, understanding and knowledge of the community and the resources to support management of chronic illness.
• Solves patient problems and needs by utilizing multidisciplinary team strategies.

Requirements

• Graduate of an accredited Nursing Program.
• Three (3) years of clinical experience in healthcare or recent case management experience.
• Strong leadership ability, good organizational skills, independent and critical thinking skills, sound judgment, and knowledge of legal aspects and liability of nursing practice.
• Strong ability to communicate complex and/or controversial topics and concepts to a wide and diverse audience.
• Proficient documentation skills.
• Knowledge of Payor/Insurance benefits.
• Functional skills on PC and related software (Microsoft Office).
• Excellent negotiation skills.
• Strong analytical, data management, and PC skills.
• Current working knowledge of utilization management, case management, and discharge planning.
• Current working knowledge of community resources, post-acute services.

Qualifications

• Specialty Essential Functions: Discharge Planning, Case Manager, Utilization Review.
• Required Qualifications: Graduate of an accredited Nursing Program, Three (3) years of clinical experience in healthcare or recent case management experience, Strong leadership ability, good organizational skills, independent and critical thinking skills, sound judgment, and knowledge of legal aspects and liability of nursing practice, Strong ability to communicate complex and/or controversial topics and concepts to a wide and diverse audience, Proficient documentation skills, Knowledge of Payor/Insurance benefits, Functional skills on PC and related software (Microsoft Office), Excellent negotiation skills, Strong analytical, data management, and PC skills, Current working knowledge of utilization management, case management, and discharge planning, Current working knowledge of community resources, post-acute services.
• Preferred Qualifications: Recent Acute Care experience, Bachelor’s Degree in Nursing, Case Management Certification preferred.

Skills

• Effective care coordination strategies that are evidence-based and outcome focused.
• Transitions of care management.
• Discharge planning and coordination.
• Utilization review and case management.
• Community resources and post-acute services.

Benefits

Not specified.

Pay

Not specified.

Schedule

Not specified.