RN Case Manager
1 month ago
As a RN Case Manager at Memorial Healthcare, you will play a critical role in facilitating optimal patient outcomes within appropriate length of stay and utilization resource parameters. You will work collaboratively with the medical staff, nursing, and ancillary departments to develop an effective plan for patient transition to home or to other post-acute care services.
Key Responsibilities- Utilize data, tools, and resources to identify patient needs, issues, and treatment goals.
- Collaborate with the Medical Staff, nursing, ancillary departments, patient, and family to establish an effective discharge plan for transition to home or post-acute care services.
- Complete internal and agency referrals to mobilize resources required for safe discharge to home.
- Collaborate with post-acute care providers to ensure an effective transition from the acute care setting.
- Document a complete and accurate assessment of the patient's post-discharge needs, discharge plan, resource referrals, etc. in the medical record.
- Complete documentation of Medical Necessity of Admission for all patients requiring an inpatient, observation, or extended recovery level of care.
- Refer cases to the Physician Advisor per established triggers/protocols and maintain PA decision documents.
- Collaborate with patient's attending physician, PA, and other utilization review staff to appeal third-party payer denials or RACs activities related to medical necessity of care.
- Participate in all committees and performance improvement activities as assigned.
- Serve as a case management resource expert for employees, the Medical Staff, patients, and families.
- Provide patient, family, employee, and Medical Staff education as appropriate.
- Demonstrate job-related aspects of patient safety to assure a safe environment, safe and effective use of equipment and technology, and decreased risk of potential adverse patient occurrence.
- Demonstrate knowledge of and supports hospital and departmental mission, vision, value statements, standards, policies, and procedures.
Must be a RN with a license to practice in the State of Michigan. Bachelor's degree in a health-related field or required to obtain a Bachelor's in a health-related field within 3 years of accepting the position. Three (3) years of clinical experience in a short-term acute care hospital setting. Prior Case Management or utilization review experience preferred. Case Management certification preferred.
Essential Physical RequirementsMust be able to sit or stand for long periods of time; be able to travel independently within the organization, including crowded or confined areas; ability to do reaching, bending, lifting, and pulling. At minimum, 75% of time spent on the job will require standing or ambulating.
Essential Mental AbilitiesMust be able to complete an assessment of a patient's medical status and develop an appropriate plan with identified discharge needs. Must be able to retrieve, interpret, and utilize information and data from multiple sources. Must be able to work effectively in situations involving high stress, interruptions, and deadlines. Must be self-motivated and able to work independently. Must be able to independently prioritize work for efficiency and timeliness of completion.
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Owosso, Michigan, United States Memorial Healthcare Full timeJob SummaryAs a RN Case Manager at Memorial Healthcare, you will play a critical role in facilitating optimal patient outcomes within appropriate length of stay and utilization resource parameters. Working collaboratively with the medical staff, nursing, and ancillary departments, you will develop an effective plan for patient transition to home or to other...
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Owosso, Michigan, United States Memorial Healthcare Full timeJob SummaryAs a RN Case Manager at Memorial Healthcare, you will play a critical role in facilitating optimal patient outcomes within appropriate length of stay and utilization resource parameters. You will work collaboratively with the medical staff, nursing, and ancillary departments to develop an effective plan for patient transition to home or to other...
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