CASE MANAGER RN

US:NV:Carson City Case Management

Part Time Day Shift

Summary

• This individual is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources while respecting patient’s right to self-determination
• This individual has the overall responsibility for ensuring that care is provided at the right level, right time and with the right resources
• The Case Manager collaborates with medical staff, interdisciplinary team, and external resources to assess, coordinate, implement, and evaluate services required to promote quality outcomes and efficient resource management

Qualifications

Required:

• Minimum 2 years of acute care hospital patient care experience required
• Preferred 2 years of experience as acute care case manager
• Current unrestricted register nurse license in the State of Nevada
• Organizational skills, excellent verbal & written communication skills, ability to lead, coordinate diverse group in fast paced environment, critical thinking, problem solving and negotiation skills

Preferred:

• Bachelor of Science in Nursing
• Ability to obtain Accredited Case Manager (ACM) certification

Essential Functions

• Promotes current National Standards for case management
• Transition management – assigns appropriate length of stay, participates in readmission prevention, transition level of care and patient satisfaction
• Utilization management – Screens for accurate medical necessity using approved evidenced based criteria, application of supporting medical necessity and denial prevention utilizing physician advisor when necessary
• Assists staff in care coordination and demonstrating efficient throughput while assuring care is sequenced and at appropriate level of care
• Develops a case management plan consistent with patient needs as identified through the assessment process; Seeks input and validation of the plan with the patient and/or family and interdisciplinary care team; Identifies and manages complex discharge needs
• Accurately conducts a thorough, objective assessment of patient’s current status, including psychosocial, physical, financial, educational needs, treatment course and services needed
• Compliance with state and federal regulations, The Joint Commission’s standards, Center for Improvement in Healthcare Quality (CIHQ), Conditions of Participation and hospital policy
• Maintains current knowledge of disease processes, available resources, and treatment options appropriate to patient population
• Collaborate with interdisciplinary team to promote patient throughput and efficient use of resources
• Continuously demonstrates a positive attitude and understanding of case management philosophy, supports team building, and is motivated to fulfill department objectives
• Assure patient/family/significant other/caregiver education is completed to support post-acute care needs and documented in electronic medical records
• Documents all activity according to policy, including the electronic automated systems
• Precept new staff members and is a resource to all staff
• Participation in department quality improvement initiatives and projects as assigned
• Performs other related duties as assigned