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RN- Health Care
2 months ago
Maria Parham Health RN-Case Manager
Job Summary
The RN Case Manager is responsible for the coordination of clinical care, quality, and financial outcomes of a designated population of patients. The RN Case Manager is responsible for overseeing an efficient plan that will ensure continuity and effective community or post-acute reentry. The RN Case Manager leads the interdisciplinary team in developing complex discharge plans.
Reports to: Director Case Management
FLSA: Non-exempt
Grade:
EEO: □ 01 Officials and Managers X 02 Professionals □ 03 Technicians □ 04 Sales Workers □ 05 Administrative Support Workers □ 06 Craft Workers □ 07 Operatives □ 08 Laborers and Helpers □ 09 Service Workers
Job Requirements
Minimum Education
associate degree in nursing required. Bachelor’s degree in nursing preferred.
Required Skills
Licenses: Current/active North Carolina or compact RN license required. AHA Basic Life Support (BLS) required. Case Management Certification, preferred.
Critical thinking skills, decisive judgment, and the ability to organize and prioritize workload to meet deadlines with minimal supervision. Must possess excellent people skills to interact with all levels of healthcare providers, support staff, and third-party payors where appropriate Excellent computer skills Must possess excellent people skills Requires a working knowledge of community resources and Utilization/Quality Review standards and activities conducted by third party payors.
Minimum Work Experience 5 years recent acute care hospital experience, required Supervisory experience, preferred Hospital case management experience strongly preferred.
Nonessential Functions
other duties as assigned.
Functional Demands
Populations Served □ Does not treat or care for patients. X Neonate (60 years)
Protected Health Information
Type of Protected Information Accessed: Demographic Clinical Insurance Financial X Complete Medical Record
Bloodborne Pathogens Exposure
While performing this job, occupational exposure is present for all employees.
Physical Requirements - Physical Dexterity and Effort: Rarely %, Bending/Stooping X rarely, □ occasionally, □ frequently, constantly Climbing X rarely, □ occasionally, □ frequently, □ constantly Keyboard Data Entry □ rarely, □ occasionally, X frequently, □ constantly Kneeling X rarely, □ occasionally, frequently, □ constantly Lifting/Moving Patients □ rarely, X occasionally, frequently, □ constantly Reaching □ rarely, □ occasionally, X frequently, □ constantly Repetitive Foot/Leg Movements □ rarely, □ occasionally, X frequently, □ constantly Repetitive Hand/Arm Movements □ rarely, □ occasionally, X frequently, □ constantly Running X rarely, □ occasionally, □ frequently, □ constantly Sitting □ rarely, X occasionally, □ frequently, □ constantly Squatting □ rarely, X occasionally, □ frequently, □ constantly Standing □ rarely, □ occasionally, X frequently, □ constantly Walking □ rarely, □ occasionally, X frequently, □ constantly Pushing / Pulling: 0-25 lbs. □ rarely, □ occasionally, X frequently, □ constantly Pushing / Pulling: 26-75 lbs. □ rarely, □ occasionally, X frequently, □ constantly Pushing/Pulling: over 75 lbs. □ rarely, □ occasionally, X frequently, □ constantly Lifting/Carrying (non-patient) : 0-25 lbs. □ rarely, □ occasionally, X frequently, □ constantly Lifting/Carrying (non-patient) : 26-75 lbs. □ rarely, X occasionally, □ frequently, □ constantly Lifting/Carrying (non-patient) : over 75 lbs. X rarely, □ occasionally, □ frequently, □ constantly
Visual Acuity, Hearing and Speaking: Rarely %, Audible Speech □ rarely, □ occasionally, □ frequently, X constantly Hearing Acuity □ rarely, □ occasionally, □ frequently, X constantly Smelling Acuity X rarely, □ occasionally, □ frequently, □ constantly Taste Discrimination X rarely, □ occasionally, □ frequently, □ constantly Vision: Depth Perception □ rarely, □ occasionally, X frequently, □ constantly Vision: Distinguish Color □ rarely, □ occasionally, X frequently, □ constantly Vision: Seeing Far □ rarely, X occasionally, □ frequently, □ constantly Vision: Seeing Near □ rarely, □ occasionally, □ frequently, X constantly
Biological: Rarely %, Biohazardous waste/ hazards □ rarely, X occasionally, □ frequently, □ constantly Blood and/or bodily fluids □ rarely, □ occasionally, X frequently, □ constantly Communicable diseases/pathogens □ rarely, X occasionally, □ frequently, □ constantly
Chemical: Rarely %, Asbestos or lead X rarely, □ occasionally, □ frequently, □ constantly Cytotoxic Chemicals X rarely, □ occasionally, □ frequently, □ constantly Dust X rarely, □ occasionally, □ frequently, □ constantly Hazardous Chemicals □ rarely, X occasionally, □ frequently, □ constantly Gases/Vapors/Fumes □ rarely, X occasionally, □ frequently, □ constantly Hazardous Medication □ rarely, X occasionally, □ frequently, □ constantly Latex □ rarely, □ occasionally, X frequently, □ constantly
Organizational Expectations
Maria Parham Health is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual’s age, color, disability, genetic information, gender, gender identity, national origin, race, religion, sexual orientation, or veteran status.
Provides a positive and professional representation of the organization.
Promotes a culture of safety for patients and employees through proper identification, reporting, documentation, and prevention.
Maintains hospital and clinic standards for a clean and quiet patient environment to maintain a positive patient care experience.
Maintains competency and knowledge of current standards of practice, trends, and developments in related scope of role or practice.
Maintains compliance with organization's policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards.
Complies with organizational and regulatory policies for handling confidential patient information.
Demonstrates excellent customer service through his/her attitude and actions, consistent with the standards contained in the Vision, Mission, and Values of the organization.
Adheres to professional standards, hospital policies and procedures, federal, state, and local requirements, and TJC standards and/or standards from other accrediting bodies.
Essential Functions
Facilitates patients care plan as called for in the plan of care
Leads daily discussions regarding patients regarding patients’ progression along the continuum
Works collaboratively as a leading member of the health team to ensure appropriate use of hospital resources, patient satisfaction, and achievement of quality of care, manages input from all healthcare professionals and conducts assessments to determine patient’s healthcare and transitional needs
Evaluates and ensures appropriateness of admissions and continued stay using evidence-based criteria.
Collaborates and manages outcomes with the payers through ongoing written and verbal communications through appropriate parties.
Leads discussions with MDs and physician advisors about safe plan for transitions.
Leads the team to ensue appropriate utilization of patient and hospital resources and directs care to other settings when appropriate.
Collaborates with community case managers and other health care advisors to ensure a smooth and safe continuum of care plan.
Conducts extensive assessments and implements interventions for patients at risk for readmissions.
Manages concurrent denials and works with physicians to overturn for appropriate reimbursement.
Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran
