RN Case Manager
4 weeks ago
The Case Manager is responsible for the clinical and financial outcomes for an assigned caseload of patients as appropriate. The Case Manager facilitates patient care during the hospitalization by managing, coordinating and monitoring resource utilization to achieve optimal clinical outcomes and financial goals. The Case Manager is responsible to proactively plan, coordinate and negotiate efficient patient movement throughout the continuum of care. In general, the Case Manager functions in the role of clinician, educator, researcher, manager and advocate to serve the best interests of the system and patient. Adheres to National Patient Safety Goals as appropriate based on the level of patient contact this position requires.
INTEGRIS is an Equal Opportunity/Affirmative Action Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.
The RN Case Manager responsibilities include, but are not limited to, the following:
Completes a comprehensive assessment of patients clinical, psychological and financial needs utilizing all available resources.
Recommends and coordinates timely transfers to appropriate levels of care as indicated by clinical needs and utilization criteria.
Develops, implements, evaluates and revises, as necessary, a plan for discharge, including referrals to other health care and community organizations based on needs assessment.
Communicates discharge care plan, and any changes in the plan to patient, family and all appropriate healthcare professionals.
Assists physicians and hospital staff in appropriate utilization of resources through application of utilization criteria and facilitating timely discharge planning for patients.
Coordinates services between hospital departments to facilitate timely patient discharge.
Conducts concurrent review of patient records on admission to the hospital and as determined by the patient's clinical condition.
Applies utilization criteria accurately in order to determine appropriate utilization of resources.
Notifies designated internal and external contacts of utilization issues that may affect patient care and/or reimbursement.
Facilitates patient transfers to other health care organizations in accordance with hospital policies and all-applicable state and federal guidelines and regulations.
Acts as a resource/advisor to physicians regarding discharge planning, medical record documentation, and all issues that may affect resource utilization and reimbursement.
Integrates and manages established pathways, where available, to enhance clinical effectiveness and clinical resource management.
Maintains knowledge and understanding of CMS regulations, Medicare/Medicaid, managed care and other payer regulations and benefit limits.
Acts as a resource and provides education for patients, their family members and all health care professionals regarding HCFA regulations, Medicare, Medicaid, managed care and other payers.
Develops and maintains knowledge and understanding of hospital and community resources, and facilitates use of most appropriate level of care to conserve patient, hospital, and payer resources.
Identifies opportunities to reduce cost of managing patient care without impacting quality or outcomes.
Participates in collecting and recording data for utilization and Quality Improvement reporting. * Works collaboratively and professionally with patients, family members, and physicians, hospital staff and other individuals and agencies involved in providing patient care.
Mental Health Only:
Leads age and developmentally appropriate patient education and recreational groups to address the emotional, physical and environmental needs of Mental Health and/or Chemically Dependent patients.
Provides documentation daily in patients' charts on each group facilitated. Facilitates discharge planning to assist patients in placement and treatment following discharge.
Participates in the development of patient plans of care to address goals of the patient (emotional, physical, spiritual, environmental) by attending treatment team meetings.
Participates in the writing of treatment plans with other program staff and physicians on hospital approved form.
Assists in utilization review process by contacting patients' insurance companies to provide clinical information to authorize patient treatment.
Serves as a patient advocate in the patients' needs, as well as those individuals involved with patients (as relevant).
Assists in the development and execution of marketing the program services to appropriate entities (outpatient therapists, primary care physicians, inpatient programs, etc.).
Completes or facilitates the completion of Emergency Detention paperwork, as well as ensure its distribution and receipt by legally designated individuals.
Provides physician ordered therapy in the areas of individual, family and marital sessions.
Develops and facilitates age and developmentally appropriate patient psychotherapeutic groups.
Is responsible for reviewing and noting physician orders.
Monitors patients' medications and provide education related to use and side effects.
Monitors vital signs as indicated by physician orders or if deemed medically necessary.
Assesses patients for appropriateness of admission to the program.
INTEGRIS Certified Case Management Only:
Documents and communicates in a timely fashion patients progression throughout the continuum of care to all necessary parties via electronic, written, and verbal means.
Apprises team members of challenges encountered throughout the continuum of care via electronic, written, and verbal means.
Utilizing strong organizational skills, personally manage evolving calendar of commitments in the best interest of the patient and organization.
Utilizing excellent interpersonal, collaborative, and conflict resolution skills, act in the capacity of liaison between the patient, medical provider, and the organization to achieve positive outcome.
For INTEGRIS Decisions Only:
Leads age and developmentally appropriate patient education groups to address the emotional, physical and environmental needs of Behavioral Health and/or Addiction Recovery patients.
Participates in the writing of treatment plans with other program staff and physicians.
Assist in utilization review process by contacting patients? insurance companies to provide clinical information to authorize patient treatment.
Serves as a patient advocate in the patients' needs, as well as those individuals involved with patient.
Completes or facilitates the completion of Emergency detention paperwork, as well as ensure its distribution and receipt by legally designated individuals.
Processes orders/refills or laboratory for ordering physician.
Monitors patient's medications and provide education related to use and side effects.
Monitors vital signs as indicated by physician orders or if deemed medically necessary.
Provides referrals options for patient's who are assessed, but do not enter the program.
Completes a comprehensive Initial Mental Health Assessment of patients clinical, psychological and financial needs utilizing all available resources.
Attends and participates in treatment team.
The Case Manager reports to the Director of the Case Management Services.
The Case Manager meets established deadlines, attends required inservices, maintains staff competencies and completes required documentation; collaborates and works as a team player with all disciplines; presents a professional image to all customers and patients.
Mental Health Case Managers report to the Unit Program Manager
INTEGRIS Certified Case Managers report to the Process Manager, Disability Mgmt.
Jim Thorpe Rehab Hospital: Reports to Mgr Post-Acute Care and Rehab
Mental Health staff must be able to assist with physical restraint of patients, utilizing the Mandt System.
This position may have additional or varied physical demand and/or respiratory fit test requirements. Please consult the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for additional information.
Required to be on call as scheduled by the department.
Potential exposure to infectious diseases, potential physical danger from disturbed/irate patients and families. Emotional stress due to inability to control volume of timing of referrals and necessity to respond to a wide variety of demands and expectations from patients, families, physicians, and other health care professionals. Occupational exposure to bloodborne pathogens and other infectious materials as defined by OSHA.
All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.
5 years experience in a variety of clinical settings (e,g. home health, inpatient, physician office, clinic) required.
Experience with managed care and payer/provider requirements preferred.
Current licensure as a Registered Nurse (RN) in the State of Oklahoma or current multistate license from a Nurse Licensure Compact (eNLC) member state.
BSN preferred.
Excellent interpersonal communication and collaboration skills.
Computer experience required. Windows preferred.
Current Case Management Certification preferred, at minimum attained within one year of hire (INTEGRIS Certified Case Management only)
Current Driver's License issued by the state of Oklahoma.
-
Registered Nurse
2 months ago
Pasco, WA, United States Professional Case Management Full timeMake a Difference on Your Own Schedule and Terms!Hiring Case Managers in Washington Come join our growing team! A few of our perks:Create your own schedule!$42/hr. (including 100% of Hourly Wage Paid for All Drive Time) Our RN-Case Managers conduct in-home nursing visits for our clients. All our clients are former Nuclear Weapon's Workers with...
-
Registered Nurse
3 weeks ago
Portsmouth, OH, United States Professional Case Management Full timeMake a Difference on Your Own Schedule and Terms!Hiring Case Managers in Ohio Come join our growing team! A few of our perks:Create your own schedule!$38/hr. (including 100% of Hourly Wage Paid for All Drive Time) Our RN-Case Managers conduct in-home nursing visits for our clients. All our clients are former Nuclear Weapon's Workers with...
-
Registered Nurse
2 months ago
Santa Fe, NM, United States Professional Case Management Full timeMake a Difference on Your Own Schedule and Terms!Hiring Case Managers in New Mexico Come join our growing team! A few of our perks:Create your own schedule!$40/hr. (including 100% of Hourly Wage Paid for All Drive Time) Our RN-Case Managers conduct in-home nursing visits for our clients. All our clients are former Nuclear Weapon's Workers with...
-
Case Management Nurse
3 weeks ago
Fresno, CA, United States Pinnacle Case Management Solutions, LLC. Full timeCompany DescriptionPinnacle Case Management Solutions, LLC provides nurse case management services to employers, third-party administrators, and insurance carriers in the Workers' Compensation industry. Our dedicated team of nurses support all parties involved in the recovery process, including the claim examiner, employer, provider, and injured worker. We...
-
RN Case Manager
2 weeks ago
, OK, United States Integris Health Full timeINTEGRIS Health Southwest Medical Center, Oklahoma’s largest not-for-profit health system has a great opportunity for a Case Manager in Oklahoma City, Oklahoma. In this position, you’ll be a part of our Case Managment team providing exceptional work supporting the INTEGRIS Health caregivers and the community at large. If our mission of partnering with...
-
RN Case Manager
4 hours ago
Tulsa, OK, United States Genie Healthcare Full timeOverview:We are seeking a dedicated Registered Nurse Case Manager to join our team. The ideal candidate will have experience in various medical settings and possess a strong background in patient care and case management.Responsibilities:- Provide comprehensive nursing care to patients- Manage and coordinate patient cases from admission to discharge- Conduct...
-
RN Case Manager
4 weeks ago
, OK, United States Integris Health Full timeINTEGRIS Health, Oklahoma’s largest not-for-profit health system has a great opportunity for a RN Case Manager in Oklahoma City, OK. In this position, you’ll work Days, Full-time, with our Case Management team providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs. If our mission of partnering with people to...
-
RN Case Manager
2 days ago
, OK, United States Integris Health Full timeINTEGRIS Health, Oklahoma’s largest not-for-profit health system has a great opportunity for a RN Case Manager in Oklahoma City, OK. In this position, you’ll work Days, Full-time, with our Case Management team providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs. If our mission of partnering with people to...
-
Case Manager
1 month ago
Tulsa, OK, United States Hillcrest Medical Center Full timeOverviewJoin our team as a evening shift, full-time, Case Management, Registered Nurse in Tulsa, OK. Fulfilling your purpose begins here: People First, Always. Here’s how we take care of our people:Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company...
-
Case Manager
2 days ago
Tulsa, OK, United States Hillcrest Medical Center Full timeOverviewJoin our team as a evening shift, full-time, Case Management, Registered Nurse in Tulsa, OK. Fulfilling your purpose begins here: People First, Always. Here’s how we take care of our people:Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company...
-
Field Nurse Case Manager
3 weeks ago
, CA, United States Pinnacle Case Management Solutions, LLC. Full timeCompany DescriptionPinnacle Case Management Solutions, LLC provides nurse case management services to employers, third-party administrators, and insurance carriers in the Workers' Compensation industry. Our dedicated team of nurses support all parties involved in the recovery process, including the claim examiner, employer, provider, and injured worker. We...
-
RN Case Manager
2 days ago
Hinton, OK, United States Good Shepherd Hospice Full timeDescription** $5,000 Sign-On Bonus**Good Shepherd Hospice is seeking a compassionate candidate for a Register Nurse Case Manager serving patients and their families in Yukon, El Reno, Weatherford, and surrounding communities.The RN provides nursing assessment, planning and care to maximize the comfort and health of patients and families. The RN responds to...
-
RN Case Manager
1 day ago
Hinton, OK, United States Good Shepherd Hospice Full timeDescription** $5,000 Sign-On Bonus**Good Shepherd Hospice is seeking a compassionate candidate for a Register Nurse Case Manager serving patients and their families in Yukon, El Reno, Weatherford, and surrounding communities.The RN provides nursing assessment, planning and care to maximize the comfort and health of patients and families. The RN responds to...
-
RN Case Manager
7 days ago
San Antonio, TX, United States UT Health San Antonio Full timeRN Case ManagerManages cases to enhance the quality of patient management and satisfaction. Promotes continuity of care and cost effectiveness through integrating functions of case management, utilization review and management, and discharge planning.
-
Case Manager
2 weeks ago
Tampa, FL, United States NeueHealth Full timeCase Manager (RN)SCOPE OF ROLE The role of the Case Manager is to promote quality, cost-effective outcomes for a population by facilitating collaboration and coordination across settings, assessing member needs, planning for care, monitoring the efficacy of interventions, and advocating to ensure member's receive services and resources required to meet...
-
RN Case Manager
3 weeks ago
Jacksonville, FL, United States Mayo Clinic Health System Full timeWhy Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans - to take care of you and your family, now and in the...
-
Registered Nurse, RN, Case Manager
3 weeks ago
Tulsa, OK, United States Family & Children's Services Full time$10,000 Sign-On Bonus! Salary commensurate with experience, offering a broad scale to accommodate varying levels of tenure/ $77,000 a year for individuals with no prior experience. Premium Medical, Dental & Vision Benefits with Zero Cost Options! Ret Registered Nurse, RN, Case Manager, Behavioral Health, Manager, Nurse, Healthcare
-
RN Case Manager
24 hours ago
Sacramento, CA, United States R.A.M. Healthcare Consulting Group, Inc. Full timeR.A.M. Healthcare Group, Inc. is seeking a dedicated Registered Nurse Case Manager to join our client's healthcare team. The Registered Nurse Case Manager is needed for a 13 week contract with our client in the Sacramento area.Responsibilities:This RN Case Manager position facilitates utilization management (UM) processes to support that the right care is...
-
Case Manager RN
1 week ago
Port Charlotte, FL, United States ShorePoint Health Port Charlotte Full timeCase Manager RNJob Description Student Loan Repayment Up to $20,000 Licensure and Certifications Reimbursement Tuition Reimbursement Robust and comprehensive benefit package At ShorePoint Health, we've cultivated an environment that nurtures professional development, promotes a sense of ownership, and naturally empowers every member of the team to align...
-
Case Manager RN
1 day ago
Port Charlotte, FL, United States ShorePoint Health Port Charlotte Full timeCase Manager RNJob Description Student Loan Repayment Up to $20,000 Licensure and Certifications Reimbursement Tuition Reimbursement Robust and comprehensive benefit package At ShorePoint Health, we've cultivated an environment that nurtures professional development, promotes a sense of ownership, and naturally empowers every member of the team to align...