RN case manager

About the role

This position comprehensively plans for targeted patient populations. Performs resource management, including denial management, utilization management, access to the appropriate level of care, discharge planning, care facilitation, and referral to other levels of care. Works collaboratively with the multidisciplinary care team to facilitate achievement of desired treatment outcomes.

Responsibilities

• Manages all aspects of transition/discharge planning for assigned patients in a timely manner.
• Collaborates with all members of the multidisciplinary team to facilitate the transition/discharge process for designated caseload.
• Maintains ongoing communication with the multidisciplinary team and post-acute providers to ensure smooth transitions.
• Provides education to staff, physicians, and patients and their families to support effective transition planning.
• Communicates with the multidisciplinary team and post-acute providers to address complex family dynamics impacting patient care.
• Initiates and facilitates referrals to post-acute services such as homecare, durable medical equipment, hospice care, long-term acute care facilities, acute rehab facilities, and skilled nursing facilities.
• Documents all interactions and transition/discharge planning activities according to departmental policy.
• Aids patients and families in completing medical power of attorney, health care surrogate, and advanced directives.

• Requirements

  • Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC).
  • Three (3) years clinical experience.

  Qualifications

  • Bachelor’s degree in Nursing (BSN).

  Skills

  • Knowledge of patient’s current medical insurance coverage and precertification requirements for Durable Medical Equipment (DME), post-acute placements, infusions, transfers, etc.
  • Knowledge of relevant scientific principles, established standards of care, and/or research findings.
  • Knowledge of procedures and techniques involved in administering routine and special treatments to patients.
  • Knowledge of and appropriate application of the nursing process.

  Benefits

  N/A

  Pay

  N/A

  Schedule

  N/A