RN Case Manager (FT) - Seacoast

Responsibilities

• Oversees the process of care delivered to patients, works collaboratively, and provides leadership to the healthcare team.
• Affirms the plan of care and services provided are patient focused, high quality, efficient and cost effective.
• Meets directly with patient/family to assess needs and develop an individualized continuing care plan in collaboration with the physician.
• Makes sure all elements critical to the plan of care have been communicated to the patient/family as well as members of the healthcare team.
• Monitors patient flow through multidisciplinary rounds and aids in implementation of processes for improvement to decrease delays.
• Serves as patient advocate to ED population by identifying needs, coordinating services and resources for the management of complex patients to facilitate quality care and cost efficient outcomes.
• Communicates information to the Utilization Management or Case Management team to aid in appropriate level of care determination and reimbursement by third party payors as well as working closely with Physician Advisory team on concurrent denials to ensure most appropriate level of care prior to billing.
• Coordinates/facilitates patient care progression throughout the continuum of care.
• Minimizes and assists with barriers to discharge.
• Assures the plan of care and services provided are patient focused, high quality, efficient and cost effective.
• Works closely with Physician Advisory team on concurrent denials to ensure most appropriate level of care prior to billing.
• Monitors length of stay and ancillary resource use on an ongoing basis and takes actions to achieve continuous improvement in both areas.
• Communicates information to the Utilization Management or Case Management team to aid in appropriate level of care determination and reimbursement by third party payors as well as working closely with Physician Advisory team on concurrent denials to ensure most appropriate level of care prior to billing.

Qualifications

• Previous Case Management Experience Is Required.
• Data entry/computer experience required.
• RN license is required.