Registered Nurse (RN) - Inpatient Case Manager - FT

About the role

Responsible for providing comprehensive assessment, planning, implementation and overall evaluation of individual patient needs; Works collaboratively with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team to assure patient management that efficiently and effectively aligns with patient needs using resources to meet quality, clinical and cost effective outcomes. Coordinates a team approach designed to facilitate the achievement of expected patient outcomes with appropriate transitions to the next level of care; Responsible for length of stay management, regulatory compliance, and attending/participating with interdisciplinary team rounds on assigned unit; Collaborates with community providers to facilitate and coordinate the plan of care for post-hospitalization needs of the patient.

Responsibilities

• Maintain knowledge of reimbursement methodologies and general coverage guidelines for all levels of inpatient and outpatient care.
• Communicate with Physician, patient/family or other team members as needed to ensure services will be covered.
• Serve as liaison to patients family, Physicians, nursing staff and all other disciplines to achieve optimal outcomes in the development of patient's discharge plan.
• Facilitate changes by communicating with Physician, mid-level or nursing staff as needed.
• Empowered to think outside of the box to consistently create new, and effective solutions to complex problems or opportunities.
• Actively supports a customer service oriented environment to continually enhance customer service.
• Communicates directly with Physicians, nursing staff, patient/family and other disciplines to ensure collaborative practice.
• Provide appropriate hand-off communication as patients transition from one unit to another to ensure and achieve optimal outcomes.
• Maintain detailed knowledge of community resources, governmental regulations, third party payers (PPO/HMO's) to facilitate appropriate outcomes.
• Completes paperwork as required.
• Consistently demonstrates a 'sense of urgency' in his/her work, while mindful of the pillars and financial stewardship opportunities.
• Works all scheduled shifts, including weekend rotation, and remote coverage.

Requirements

Minimum Job Qualifications:

• Licensure or other certifications: Licensed to practice as an RN in Georgia.
• Educational Requirements: Associate degree.
• Minimum Experience: Three (3) to five (5) years of experience in direct patient care and/or case management.

Qualifications

Preferred Job Qualifications:

• Licensure or other certifications: CCM (Case Management Certification) or ACM (American Case Management Certification) preferred.
• Preferred Educational Requirements: Bachelors Degree.

Skills

Working knowledge of State and Federal regulations required.