Nurse Case Manager

Company: TRIUNE Health Group RedBalloon posts jobs on behalf of client companies Job Summary The Nurse Case Manager coordinates resources and creates flexible, cost-effective options for catastrophically or chronically ill or injured individuals to facilitate quality, individualized, holistic treatment goals, including timely return to work when appropriate. Responsibilities Provide medical case management to individuals through coordination with the patient, physicians, other health care providers, the employer, and the referral source.Utilize the steps of Case Management to provide assessment, planning, implementation, evaluation, and outcome of an individual’s progress.Evaluate individual treatment plans for appropriateness, medical necessity, and cost-effectiveness.Facilitate care, such as negotiating and coordinating the delivery of durable medical equipment andhome health services, ensuring clear communication.Assess rehabilitation facilities for appropriateness of care, facilitate transportation, and coordinate architectural assessments of patients’ homes when required.Communicate medical information clearly and compassionately to patients and families.Stay current with medical terminology and the federal and state laws related to health care,Workers’ Compensation, ADA, HIPAA, FMLA, STD, LTD, SSDI, and SSA.Utilize technology (computer, cell phone, fax, and scanning machine) to prepare organized, timely reports while complying with safety rules and regulations in conjunction with HIPAA.Research medical and community resources for individuals with catastrophic or chronic diagnoses, such as but not limited to AIDS, cancer, spinal cord injuries, diabetes, head injuries, back injuries, hand injuries, and burns, ensuring accessibility for individuals.Possess a valid driver’s license with the ability to travel 90% of the time.Perform other duties as assigned.