Nurse Case Manager
3 days ago
At TRIUNE Health Group Inc, we are seeking a skilled and compassionate Nurse Case Manager to join our team. As a key member of our healthcare team, you will play a vital role in coordinating resources and creating effective treatment plans for individuals with catastrophic or chronic illnesses.
Key Responsibilities:- Provide medical case management to individuals through coordination with patients, physicians, healthcare providers, employers, and referral sources.
- Utilize the Case Management process to assess, plan, implement, evaluate, and outcome individual progress.
- Evaluate treatment plans for appropriateness, medical necessity, and cost-effectiveness.
- Facilitate care by negotiating and coordinating the delivery of durable medical equipment and home health services.
- Assess rehabilitation facilities for appropriateness of care, facilitate transportation, and coordinate architectural assessments of patients' homes when required.
- Stay current with medical terminology and federal and state laws related to healthcare, Workers' Compensation, ADA, HIPAA, FMLA, STD, LTD, SSDI, and SSA.
- Utilize technology to prepare organized and timely reports while complying with safety rules and regulations in conjunction with HIPAA.
- Research medical and community resources for individuals with catastrophic or chronic diagnoses.
- Possess a valid driver's license with the ability to travel 90% of the time.
- Graduate of an accredited school of nursing.
- Current RN licensure in the state of operation.
- Three or more years of recent clinical experience, preferably in trauma, psychology, emergency, orthopedics, rehabilitation, occupational health, and neurology.
- CCM certification preferred.
- COHN, COHN-S, and CDMS certifications.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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