![Prisma Health](https://media.trabajo.org/img/noimg.jpg)
RN-Hospital Case Manager
1 month ago
Inspire health. Serve with compassion. Be the difference.
Job Summary
The Hospital Care Manager (HCM) is an integral care team partner that focuses on patient engagement and activation, has primary accountability for patients' care transition out of the acute care setting and positively impacts longitudinal care plan alignment. In collaboration with physicians, leads the multidisciplinary team including clinical staff and payors to ensure efficient delivery of quality, cost-effective care. The HCM leads the team for each patient individually with the goal to maximize autonomy where possible.Accountabilities
- Partners with the attending providers throughout hospitalization to promote effective and efficient utilization of clinical resources, ensuring quality, cost effective care. Anticipate next steps and facilitate communication to maximize care efficiencies for the patient and family. 10%
- Identifies social determinants of health that increase the patient's risk for negative outcomes. Ensures clear documentation for the interdisciplinary care team and coordinates post-acute plans with the ambulatory care management team as appropriate. Facilitates patient access to resources and relevant services. 10%
- Addresses and resolves system problems impeding diagnostic or treatment progress. Proactively identifies, resolves and documents delays and obstacles on the patient's behalf. Drives change by identifying areas where performance improvement is needed. 10%
- Navigates value based care with expertise and ensures longitudinal plan is patient focused and aligns with patient and caregiver goals. 10%
- On the basis of preliminary risk screening, assesses patients' and family's psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, reaction to illness and ability to cope. 10%
- Maintains expert level knowledge of body systems and expected clinical outcomes for patient disease process. Maintains current knowledge of changes in state and federal regulatory requirements related to the provision of care management services in an acute care setting. Maintains care management knowledge to provide services in accordance with standards of practice as established by department and management. 10%
- Ensures medical necessity, appropriate level of care and timely implementation of plan of care in accordance with hospital(s) Utilization Review Plan. 10%
- Navigates the team through complex compliance, regulatory and insurance requirements. Coordinates with third party payors on a regular basis. 10%
- Serves as a resource for patients and families with regard to their rights and responsibilities, when payment of care is denied or when care is no longer medically necessary. Includes, but not limited to, delivery of the regulatory documents as provided by CMS. 10%
- Advocates for patient and family empowerment and independence to make autonomous health care decisions and access needed services within the health care system. 10%
Minimum Qualifications
- Education - Bachelors degree in nursing
- Experience - Three (3) years acute care nursing experience. One (1) year acute care/ case management experience preferred.
Required Licensure
Licensed to practice as a Registered Nurse in South Carolina
Other Required Skills/Experience
Accredited Case Manager (ACM) or Certified Case Manager (CCM) is preferred.
Knowledge of Medical Necessity Criteria is preferred.
In Lieu of
In lieu of the BSN requirement above, a nursing diploma or an Associate's Degree in Nursing may be considered if the applicant signs a BSN Memorandum of Understanding (MOU) agreeing to enroll in an accredited BSN or MSN program within one year and obtain a BSN or MSN degree within (4) four years of hire date.
Further, employees must demonstrate sufficient progress annually toward obtaining an accredited BSN or MSN degree to remain eligible for employment or may be terminated. - Required
Grandfather Status
Employees in this title prior to 10/24/2021 are grandfathered into the title and are only required to have an AD N or Nursing Diploma.
Work Shift
Day (United States of America)Location
Oconee Medical CampusFacility
1064 Oconee Memorial HospitalDepartment
OMH Hospital Care MgmtShare your talent with us Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
-
RN-Hospital Case Manager
3 days ago
Columbia, SC, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference.Job SummaryThe Hospital Case Manager (HCM) provides case management service for hospital patients, including, but not limited to, utilization management to ensure efficient, cost-effective patient progression through the continuum of care and discharge to an appropriate level of care. In collaboration...
-
RN-Hospital Case Manager
3 days ago
Columbia, SC, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference. Job Summary The Hospital Case Manager (HCM) provides case management service for hospital patients, including, but not limited to, utilization management to ensure efficient, cost-effective patient progression through the continuum of care and discharge to an appropriate level of care. In...
-
RN-Hospital Case Manager
3 days ago
Columbia, SC, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference. Job Summary The Hospital Case Manager (HCM) provides case management service for hospital patients, including, but not limited to, utilization management to ensure efficient, cost-effective patient progression through the continuum of care and discharge to an appropriate level of care. In...
-
Manager Case Management RN
4 weeks ago
Asheville, NC, United States Mission Hospital Full timeDescription IntroductionWe are seeking a(an) Manager Case Management RN with Mission Hospital to promote growth and unlock possibilities. At HCA Healthcare, we are committed to the care and improvement of human life. Share your leadership skills and come make a difference with us!BenefitsMission Hospital, offers a total rewards package that supports the...
-
RN-Hospital Case Manager
3 days ago
Columbia, SC, United States Prisma Health Full timeInspire health. The Hospital Case Manager (HCM) provides case management service for hospital patients, including, but not limited to, utilization management to ensure efficient, cost-effective patient progression through the continuum of care and discharge to an appropriate level of care. In collaboration with physicians, leads the multidisciplinary team...
-
RN CASE MANAGER
3 months ago
Philadelphia, PA, United States Temple University Hospital Full timeRN CASE MANAGER - (Temple/Chestnut Hill Hospital - 24 hours days)The Case Manager is a registered nurse responsible for coordinating the care and services for an assigned unit-based patient population. The Case Manager promotes quality of care, supports effective resource utilization, and facilitates the patient's progression of care to proactively plan for...
-
RN Case Manager
4 weeks ago
San Antonio, TX, United States Methodist Hospital Full timeDescription IntroductionMethodist Hospital is committed to investing in the latest technology enabling nurses to work more efficiently. Are you passionate about delivering patient-centered care? Submit your application for RN Case Manager position and spend more time at the bedside with the patient.BenefitsMethodist Hospital, offers a total rewards package...
-
RN Case Manager
2 days ago
San Antonio, TX, United States Methodist Hospital Full timeDescription IntroductionMethodist Hospital is committed to investing in the latest technology enabling nurses to work more efficiently. Are you passionate about delivering patient-centered care? Submit your application for RN Case Manager position and spend more time at the bedside with the patient.BenefitsMethodist Hospital, offers a total rewards package...
-
RN Case Manager
13 hours ago
San Antonio, TX, United States Methodist Hospital Full timeDescription IntroductionMethodist Hospital is committed to investing in the latest technology enabling nurses to work more efficiently. Are you passionate about delivering patient-centered care? Submit your application for RN Case Manager position and spend more time at the bedside with the patient.BenefitsMethodist Hospital, offers a total rewards package...
-
Philadelphia, PA, United States Temple University Hospital Full timeRN - CASE MANAGER - (Temple University Hospital/40 hours days)In collaboration with the patient/family, physicians, and the interdisciplinary team, the Case Manager facilitates the patient's progress through the acute episode of care in an efficient and cost effective manner. Monitors the level of care, initiating evidence based protocols and order sets...
-
Case Manager RN
1 month ago
Philadelphia, PA, United States Thomas Jefferson University Hospital Full timeCase Manager RNResponsibilities 004015 Join the mission of Improving Lives as a Case Manager RN at Jefferson Health. With more than 42,000 employees, we're the second largest employer in Philadelphia and the largest health system in the Philadelphia region. And our work to improve lives is never done. Case Manager RNs are responsible for the following: *...
-
Case Manager, RN
2 months ago
Philadelphia, PA, United States Thomas Jefferson University Hospital Full timeCase Manager, RNResponsibilities 004015 Join the mission of Improving Lives as a Case Manager RN at Jefferson Health. With more than 42,000 employees, we're the second largest employer in Philadelphia and the largest health system in the Philadelphia region. And our work to improve lives is never done. Case Manager RNs are responsible for the...
-
Manager Case Management RN
2 months ago
Asheville, NC, United States Mission Hospital Full timeDescription IntroductionWe are seeking a Manager Case Management RN with Mission Hospital to promote growth and unlock possibilities. At HCA Healthcare, we are committed to the care and improvement of human life. Share your leadership skills and come make a difference with us!BenefitsMission Hospital, offers a total rewards package that supports the health,...
-
Case Manager RN
4 weeks ago
Philadelphia, PA, United States Thomas Jefferson University Hospital Full timeCase Manager RNResponsibilities 004015 Join the mission of Improving Lives as a Case Manager RN at Jefferson Health. With more than 42,000 employees, we're the second largest employer in Philadelphia and the largest health system in the Philadelphia region. And our work to improve lives is never done. Case Manager RNs are responsible for the following: *...
-
RN Case Manager
2 weeks ago
Bountiful, UT, United States Lakeview Hospital Full timeDescription IntroductionDo you have the career opportunities as a(an) RN Case Manager you want in your current role? We invest in what matters most to nurses like you – at home, at work, and at every stage in your career. We have an exciting opportunity for you to join Lakeview Hospital which is a part of the nation’s leading provider of healthcare...
-
RN CASE MANAGER
1 month ago
Philadelphia, PA, United States Temple University Hospital Full timeRN CASE MANAGER - (Temple/Chestnut Hill Hospital - 40 hours days)The Case Manager is a registered nurse responsible for coordinating the care and services for an assigned unit-based patient population. The Case Manager promotes quality of care, supports effective resource utilization, and facilitates the patient's progression of care to proactively plan for...
-
RN, Case Manager
2 months ago
Elko, NV, United States Northeastern Nevada Regional Hospital Full timeJob DescriptionNortheastern Nevada Regional Hospital – Case ManagerWho We Are:People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Northeastern Nevada Regional Hospital is a 75-bed facility located in Elko, Nevada. We offer a wide range of healthcare services, including emergency medicine,...
-
RN Case Manager
3 weeks ago
Live Oak, TX, United States Methodist Hospital Northeast Full timeDescription IntroductionLast year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) RN Case Manager with Methodist Hospital Northeast you can be a part of an organization that is devoted to giving back!BenefitsMethodist Hospital Northeast, offers a total rewards package that supports the health, life, career...
-
RN Case Manager
1 month ago
Live Oak, TX, United States Methodist Hospital Northeast Full timeDescription IntroductionLast year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) RN Case Manager with Methodist Hospital Northeast you can be a part of an organization that is devoted to giving back!BenefitsMethodist Hospital Northeast, offers a total rewards package that supports the health, life, career...
-
Case Manager RN
3 weeks ago
Philadelphia, PA, United States Thomas Jefferson University Hospital Full timeCase Manager RNResponsibilities 004015 The Case Manager RN utilizes advanced nursing skills and knowledge to comprehensively coordinate care for a defined patient population to facilitate patients through the continuum of care. Coordinates all aspects of discharge planning and establishes a safe discharge plan for assigned...