RN Case Manager - St. Mary

Job Duties

• Performs pre-admission, admission, and continued stay reviews as directed per CMS guidelines, commercial payer guidelines, and/or hospital policy.
• Supports the values of Service Excellence, Teamwork and Integrity, maintains minimum standards for licensure and strives for personal/professional development.
• Maintains knowledge of the Conditions of Participation as it relates to utilization review and discharge planning.
• Supports the values of Service Excellence, Teamwork and Integrity, maintains minimum standards for licensure and strives for personal/professional development.
• Maintains open communication with all appropriate parties while functioning as a liaison between ED physicians, hospitalists, attending physicians, and Physician Advisors.
• Leads the oversight and management of the functional and financial outcomes, including coordination and implementation of the discharge plan, during the acute-care hospitalization.
• Adapts behavior to the specific patient population, including but not limited to: respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions and communication style.

Education & Experience

Education Required - Registered Nurse Diploma or equivalent
Work Experience Preferred - Bachelors degree in Nursing Required - 3 Years Hospital-based Experience.
Preferred - Experience in discharge planning, case management or utilization review.

Skills & Abilities

Must have computer skills and dexterity required for data entry and retrieval of patient information.
Must be proficient with Windows-style applications and keyboard.
Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
Strong interpersonal skills.

Physical Demands

Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects.

Other Related Duties

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.