RN Case Manager PRN

Core Functions

• Manages individual patients across the health care continuum to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
• Acts in a leadership function with process improvement activities for populations of patients to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
• Acts in a leadership function to collaboratively develop and manage the interdisciplinary patient discharge plan.
• EFFECTIVELY communicates the plan across the continuum of care.
• Evaluates the medical necessity and appropriateness of care, optimizing patient outcomes.
• Affirms patient admissions and continued stay utilizing standard criteria.
• Identifies issues that may delay patient discharge and facilitates resolution of these issues.
• Establishes and promotes a collaborative relationship with physicians, payers, and other members of the health care team.
• Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements.
• EDUCATES internal members of the health care team on case management and managed care concepts.
• Facilitates integration of concepts into daily practice.
• MAY supervise other staff.
• CONFERS with supervisor on any unusual situations.

Minimum Qualifications

• Must possess knowledge of case management or utilization review as normally obtained through the completion of a bachelor's degree in case management or health care.
• Requires current Registered Nurse (R.N.) license in state worked.
• For assignments in an acute care setting, Basic Life Support (BLS) certification is also required.
• Requires a proficiency level typically achieved with 3-5 years clinical experience.
• Must have a working knowledge of care management, acute care and/or home care environments, community resources and resource/utilization management.
• MUST demonstrate critical thinking skills, problem-solving abilities, effective communication skills, and time management skills.
• MUST demonstrate ability to work effectively in an interdisciplinary team format.
• For assignments in an acute care setting, MUST be able to work flexible hours and take rotating call after hours.

Preferred Qualifications

• CCM (Certified Case Manager) preferred.