Case Management Manager

2 weeks ago


Boulder City, Nevada, United States Boulder City Hospital Full time
false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4



GENERAL PURPOSE:

Effectively performs Case Management and Utilization Review functions and assists with hospital-wide Quality Improvement Monitoring and Infection Control as needed.


ESSENTIAL FUNCTIONS:

Primary responsibilities of the Case Management/Utilization Review RN include case management, discharge planning, social services and utilization management of patients to ensure they receive quality, medically appropriate care in the most appropriate setting.

Able to lift, walk, carry and stand.

DUTIES AND RESPONSIBILITIES:

  • Performs patient assessments of all major domains (physical, functional, financial, and psychosocial).
2.

Assists the care team in developing individualized care plans that involve provider and patient choices and goals for care to include assessment, planning and implementing care strategies that are directed toward the most appropriate, least restrictive level of care, that includes acute care and post hospital care.

3. Implements care plans involving health care resources across the continuum.

4.

Monitors and evaluates care plan to ensure quality health outcomes are achieved, including education of patients/families on how to follow their post hospital plans of care.

5. Utilize both hospital and community based resources to establish a safe and effective case management plan for patients.

6.

Communicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to patients.

7.

Advocate for patients and families as needed to ensure that the patient's needs and choices are fully represented and supported by the health care team.

8.

Utilize approved clinical criteria (Interqual, Milliman, etc.) to assess and determine appropriate level of care for patients and to provide clinical information to Medicare, Medicaid and private health plans as requested on an ongoing basis.

9. Understand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the patients health plan.

10. Educating patients/families on their benefits and limitations of their Medicare, Medicaid or private health care coverage

11. Be accountable for understanding role and how it affects utilization management benchmarks and quality outcomes.

12. Continues self-education by reviewing current literature, attending workshops, seminars and formal courses relating to Case Management and Utilization Review.

13. Assists in the maintenance of records and resources for Case Management.

14. Keep Case Management Manager informed of departmental activities, needs and problems.

15. Maintain close liaison with other hospital departments to assure coordination, standardization and continuity of patient care.

16. Perform community outreach education as needed.

17. Participate in hospital-wide Quality Improvement and Infection Control activities as needed.

18.

May be asked to provide direct patient care, such as bathing, dressing, and feeding patients, along with assisting in examinations and treatments in extreme or crisis situations.


SKILLS AND ABILITIES REQUIRED:

1. Ability to pass high efficiency respiratory fit test and use program as required by OSHA, Vol. 58, No. 195.

2. Ability to effectively communicate orally and in writing.

3. Must be able to work independently with minimal supervision showing initiative and being a self-starter.

4.

Ability to work effectively with all hospital staff to ensure a spirit of harmony, cooperation and excellence in patient care and satisfaction.


EDUCATION AND EXPERIENCE REQUIRED:

  • Graduate from an accredited School of Nursing.
2. Current Nevada State RN Licensure or eligible for licensure.

3. Preferable professional organization membership on a state or national level pertaining to Case Management/Utilization Review.

4. Minimum 3 years Case Management/Utilization Review experience.

5. Knowledge and/or experience with Interqual or similar criteria software.

6. Knowledge of computers, including WORD, EXCEL and EHR
  • Case Investigator

    2 weeks ago


    Carson City, Nevada, United States CDC Foundation Full time

    State Funded Programs (SFP) – Nevada- SFP /Location: This position requires residency in Las Vegas, Reno, or Carson City and will be working remotely for the foreseeable future. This position will be transitioning to 1-2 days in-office attendance after the first few weeks of employment.The CDC Foundation is seeking a General Communicable Disease (GCD) Case...

  • Shift Lead

    2 weeks ago


    Boulder City, Nevada, United States ST. JUDES RANCH FOR CHILDREN Full time

    ***$1,000 HIRING BONUS*** With completion of termsSUMMARY OF JOB PURPOSE: Providing care for teen girls who are at high risk to include confirmed CSEC, at high risk for CSEC or those in need of a higher level of care for stabilization and assessment . This program will provide victim-centered residential services that will be complemented with high quality...

  • Youth Care Specialist

    2 weeks ago


    Boulder City, Nevada, United States ST JUDES Full time

    Job Description Job Description Description:$1,000 HIRING BONUSWith completion of terms7 am - 3 pm, shift, 3 pm - 11 pm shift, and 11 pm - 7 am shift are neededSUMMARY OF JOB PURPOSE:Providing care for teen girls who are at high risk to include confirmed CSEC, at high risk for CSEC or those in need of a higher level of care for stabilization and assessment ....

  • Museum Curator

    22 hours ago


    Boulder City, Nevada, United States National Park Service Full time

    Manage and maintain preservation, security and fire protection, and storage conditions for park museum collections, archives, and libraries. Provide overall professional and technical direction and priorities for the museum collection program, ensuring NPS and professionally recognized collections management procedures are applied in all operations. Maintain...

  • Shift Manager

    2 weeks ago


    Carson City, Nevada, United States Arby's Restaurant Full time

    Shift Managers are responsible for: Assisting the General Manager and Assistant Manager with all facets of the successful operations for an Arby's Restaurant. Providing a high level of leadership to the restaurant and the employees. Supporting the Ge Shift Manager, Assistant Manager, Manager, General Manager, Management


  • Boulder City, Nevada, United States National Park Service Full time

    Major Duties include:Developing and managing internal and external strategic communications projects, including producing press releases, producing and implementing communications plans, and conducting media interviews. Representing the park in official and public meetings. Advising staff on public affairs matters. Managing the park's Freedom of Information...

  • Assistant Manager

    1 month ago


    Carson City, Nevada, United States Jack In The Box Full time

    Jack In The Box Avalon Blvd [Restaurant Supervisor] As an Assistant Manager at Jack In The Box, you'll:Manage the restaurant operations in conjunction with, or in the absence of, the Restaurant Manager; Find, train, develop and recognize the best people; Manage daily activities to ensure guests receive excellent customer service; Serve as a strong role model...

  • General Manager

    2 weeks ago


    Carson City, Nevada, United States Gecko Hospitality Full time

    Our Restaurant Manager must be able to find the positive in life, especially when the challenges are great, have enough energy to feed huge families on a daily basis, realize communicating is more about listening than talking and be sincerely devoted General Manager, Restaurant Manager, Manager, Staffing


  • Boulder City, Nevada, United States Aviation Search Group Full time

    Our client stands as a leading global provider renowned for their excellence in engineering, maintenance, and aircraft leasing services, catering to both helicopter and fixed-wing aircraft. In pursuit of further strengthening their presence in the United States market, they are actively seeking a Vice President of MRO & Aircraft Sales. This pivotal role will...

  • Assistant Manager

    2 weeks ago


    Carson City, Nevada, United States Arbys Full time

    We are searching for a new Assistant Manager to join our team who is interested in helping tohire and train other team members. You will also assist in making sure the team adheres tocompany policies, resolving customer complaints, leading the team, and organizing the teamschedule.To be a great fit for this role you should have a consistent work history and...

  • Assistant Manager

    4 weeks ago


    Carson City, Nevada, United States Arbys Full time

    We are searching for a new Assistant Manager to join our team who is interested in helping tohire and train other team members. You will also assist in making sure the team adheres tocompany policies, resolving customer complaints, leading the team, and organizing the teamschedule.To be a great fit for this role you should have a consistent work history and...

  • Locum Tenens

    2 weeks ago


    Boulder City, Nevada, United States Delta Locum Tenens Full time

    Start Date: ASAPSpecialty: Family NP State: NevadaReason For Coverage: Provider going out on surgery starting May 17th Dates & Required Availability: Start May 17 – for 3 months to startShift & Call Details:Monday - Friday 8am-5pm Job Details: Clinic Setting Patient Volume: 18 Required Procedures: bumps and bruises blood pressure checks/management pain...

  • Locum Tenens

    4 weeks ago


    Boulder City, Nevada, United States Delta Locum Tenens Full time

    Start Date: ASAPSpecialty: Family NP State: NevadaReason For Coverage: Provider going out on surgery starting May 17th Dates & Required Availability: Start May 17 – for 3 months to startShift & Call Details:Monday - Friday 8am-5pm Job Details: Clinic Setting Patient Volume: 18 Required Procedures: bumps and bruises blood pressure checks/management pain...


  • Boulder City, Nevada, United States National Park Service Full time

    Public Safety Dispatching Land Mobile Radio System Dispatch Console operations Operates and Troubleshoots Public Safety Computer Networks Fire and Security Alarm and Closed Circuit TV monitoring Records Management for Criminal Justice InformationDuties will be developmental in nature when filled below the full performance level.A selectee receiving a first...


  • Boulder City, Nevada, United States National Park Service Full time

    Positions are in the Invasive Plant Management Team.This position typically includes 7 consecutive nights away from home twice a month equaling an average of 14 nights away from home per month.Some of the duties you will perform include, but are not limited to:Conduct invasive plant control projects using a variety of methods in remote natural settings....


  • Boulder City, Nevada, United States National Park Service Full time

    Positions are in the Invasive Plant Management Team.This position typically includes 7 consecutive nights away from home twice a month equaling an average of 14 nights away from home per month.Some of the duties you will perform include, but are not limited to:Conduct invasive plant control projects using a variety of methods in remote natural settings....

  • Manager HR

    4 weeks ago


    Carson City, Nevada, United States Howmet Aerospace Full time

    Job Description Summary We are seeking a Plant HR Manager for our Howmet Fastening Systems manufacturing facility in Carson, CA. The Plant HR Manager role designs and executes human resources strategies for the betterment of employees and the business.This role has direct reports and will partner directly with the site Operational Director while also...

  • Manager HR

    1 month ago


    Carson City, Nevada, United States Howmet Aerospace Full time

    Job Description Summary We are seeking a Plant HR Manager for our Howmet Fastening Systems manufacturing facility in Carson, CA. The Plant HR Manager role designs and executes human resources strategies for the betterment of employees and the business.This role has direct reports and will partner directly with the site Operational Director while also...

  • program manager

    2 months ago


    Carson City, Nevada, United States Department Of The Army Full time

    SummaryThis position is for a Program Manager (Deputy USP&FO), PD# T5275P01, part of the Nevada National Guard. The primary purpose of this position is to serve as a full deputy to the United States Property and Fiscal Officer. The Deputy USPFO will take appropriate action, immediately notifying the USPFO, the Adjutant General (AG) and/or CNGB (as...

  • program manager

    4 weeks ago


    Carson City, Nevada, United States Department Of The Army Full time

    SummaryThis position is for a Program Manager (Deputy USP&FO), PD# T5275P01, part of the Nevada National Guard. The primary purpose of this position is to serve as a full deputy to the United States Property and Fiscal Officer. The Deputy USPFO will take appropriate action, immediately notifying the USPFO, the Adjutant General (AG) and/or CNGB (as...