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Nurse Case Manager
2 months ago
Job Summary
The RN Case Manager serves to coordinate quality and cost-effective health and social care for clinically complex patients. Assesses the patients' clinical level of care and needs to ensure they meet the criteria for admission and continued stay. This is achieved through effective communication regarding the coordination of services with the interdisciplinary care team, patients, their support system, and payers. Initiates and facilities follow-up services for post-hospital care that may include physician visits, home health care, hospice, medical equipment and supplies, outpatient services, etc. If alternate placement is necessary, the Case Manager coordinates the referral, approval, and placement process.
Core Responsibilities And Essential Functions
- Conducts Utilization Review timely and in accordance with utilization Review plan
- Conducts initial assessments upon admission and provides weekly family updates
- Coordinates and facilitates weekly interdisciplinary team meetings
- Coordinates discharge planning process for all patients
- Serve as CM Representative on Committees such as the Utilization Review Committee, Clinical Practice Team, JC Preparedness team, Stroke Team, etc.
- Supervise the non-RN Case Managers.
- Other duties as assigned.
- Associate's degree in Nursing Required
- Bachelor's Degree in Nursing Preferred
All certifications are required upon hire unless otherwise stated.
- Current American Heart Association, Basic Life Support (BLS). Required
- Licensed to practice as Professional Registered Nurse in the State of Georgia or have an active Multi-State Registered Nurse Compact License
- Work Environment Indicates the typical Required
- CCM Preferred
Currently licensed as a Registered Nurse in the State of Georgia or hold a privilege to practice in the State of Georgia under the Enhanced Nurse Licensure Compact (eNLC). Required and
Must have a current BLS card from the American Heart Association on the first day of employment in position.
Required
Required Minimum Experience:
- 2 year(s) or more of experience in Nursing Required
- 2 year(s) or more of experience in a Rehab or LTAC Hospital w/ case management experience Preferred
Should possess excellent verbal and written communication skills and relationship building; a knowledge of the health care environment; leadership that includes such skills as successfully implementing and managing a change process ability to use systems thinking- and inspire, coach others to be successful; model the way for professional practice; professionalism and teamwork/collaboration for self/department/medical staff; and possess necessary business skills to manage human and material resources.
Must be a continuous learner who understands health care financing; strategy and operations for running a business unit(s); and effectively employ data and technology to support work processes and make decisions.
Supports shared governance or shared decision making; manage the design and delivery of care that in based on evidence and focused on quality and safety.
Knowledge of risk management and various accreditation/regulations/licensing requirements assuring that these are upheld while advancing industry standards through the achievement of goals by effective management and measurement of outcomes.
