Nurse Case Manager

4 weeks ago


Hamtramck, Michigan, United States Detroit Medical Center Full time

Job Summary:

As a Case Management Registered Nurse at the Detroit Medical Center, you will play a critical role in ensuring the delivery of high-quality patient care. You will be responsible for managing and operational oversight for the Case Management and Social Work/Discharge Planning departments at the assigned DMC hospital(s), in collaboration with hospital and system leadership.

Key Responsibilities:

  • Develop and implement education and orientation programs for personnel.
  • Identify the need for and drafts or defines procedures/protocols in collaboration with higher management input, goals and objectives; modifies procedures/protocols as necessary.
  • Monitors the quality and productivity of staff to ensure work is completed.
  • Approves personnel actions such as hires, fires, disciplines, etc.
  • Completes performance appraisals and ensures competency of staff.
  • Assists in the development of daily, monthly and/or yearly goals and measures for department, and as requested, assists in assessment of goal attainment.
  • Assists in developing and monitoring budget.
  • Maintains accountability for patient coverage and related activities among assigned staff members.
  • Maintains accountability for third party payer communications for discharge planning and decision-making.
  • Monitors activities for and ensures compliance with laws, third party payer requirements, government regulations, Joint Commission requirements pertaining to areas of responsibility.
  • As directed, implements external and internal audit recommendations.
  • Engages physician advisor to facilitate care decisions, as needed.
  • Maintains current knowledge of health care techniques/practices, and case management strategies through educational programs/resources.
  • Maintains a working knowledge of the requirements of payers, regulatory and compliance entities.
  • Establishes and maintains effective relationships with physicians and all other staff members, internally and externally.
  • Identifies problems or any dissatisfaction experienced by any customer or referring source and works to resolve them to a high degree of service excellence.
  • Effectively turns negative situations into supportive relationships by use of concern, poise, understanding, honesty and tact.
  • Promotes a positive customer relations environment.

Qualifications:

  • Graduate from an accredited school of Nursing. Bachelors degree in Nursing or other health-related field, or the equivalent combination of education and/or related experience. Masters degree preferred.
  • Three to five years clinical nursing experience.
  • Two years experience in utilization management, case management or discharge planning in an acute care setting. Previous experience with the targeted patient population is preferred.
  • Two years of management experience in an acute care setting.
  • License to practice as a Registered Nurse in the State of Michigan.
  • Case Management certification strongly preferred.

Job Type: Full-time

Shift Type: Day

Location: Detroit, Michigan

Facility: DMC Harper University/Hutzel Women's Hospital


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