CASE MANAGER SUPPORT

Department: Integrated Care Management (Support) | Facility: Upper Valley Medical Center | Position status: PRN

Responsibilities

Under the general supervision of the Manager of Integrated Care Management, the Care Manager works collaboratively with the Care Management Team to ensure cost‑effective, quality care throughout the continuum of healthcare.

• Review patients’ medical records for care‑management activities, including discharge/transition planning, clinical documentation, utilization‑management issues (recidivism/length of stay, care delays and avoidable days), admission/continued‑stay reviews, status issues, and providing severity/intensity of illness criteria for CMS and third‑party payers; make referrals to Social Services, Home Care Liaison, and Patient Education.
• Participate in risk‑management and quality‑measure initiatives such as recidivism tracking, core measures, missing H&Ps, post‑operative notes, etc.
• Maintain direct contact with patients, families, and providers; join daily unit “huddles” for care coordination and identification of discharge barriers; actively support patient and physician satisfaction goals.
• Mentor and serve as a resource to other health‑care providers on care‑management techniques and quality issues.
• Provide care to a patient population ranging from newborns to elderly individuals, based on specific assignments.

Qualifications

• BSN (Bachelor of Science in Nursing) from an accredited School of Nursing.
• Current Ohio State license as a Registered Nurse.
• Three to five years of recent acute‑care experience, with knowledge of utilization and case‑management principles.
• Professional knowledge of nursing theory and practice.
• Additional nursing continuing education preferred.
• Strong interpersonal skills to instruct and comfort patients and families and maintain effective contacts with a variety of hospital personnel.
• Ability to recognize and reinforce positive efforts of co‑workers.
• Analytical skills for problem solving and conflict resolution.
• Basic computer skills; experience with Microsoft Word and Access preferred.