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RN Case Manager I Case Management FT Days

1 month ago

Birmingham, Alabama, United States Princeton Medical Center Full time

Job Summary

The RN Case Manager is responsible for facilitating care along a continuum through effective resource coordination to help patients achieve optimal health, access to care, and appropriate utilization of resources. This position integrates national standards for case management scope of services, including utilization management, transition management, care coordination, and compliance with state and federal regulatory requirements.

Responsibilities

The individual's responsibilities include:

  • Accurate medical necessity screening and submission for Physician Advisor review
  • Care coordination and transition planning assessment and reassessment
  • Implementation or oversight of implementation of the transition plan
  • Leading and facilitating multi-disciplinary patient care conferences
  • Managing concurrent disputes and making appropriate referrals to other departments
  • Identifying and referring complex patients to Social Work Services
  • Communicating with patients and families about the plan of care
  • Collaborating with physicians, office staff, and ancillary departments
  • Leading and facilitating Complex Case Review
  • Assuring patient education is completed to support post-acute needs
  • Timely, complete, and concise documentation in Case Management system
  • Maintenance of accurate patient demographic and insurance information
  • Identification and documentation of potentially avoidable days
  • Identification and reporting over and underutilization

Requirements

Required:

  • Graduate of an accredited school of nursing
  • 2 years of acute hospital patient care experience
  • Active RN license for state(s) covered

Preferred:

  • Academic degree in nursing (bachelor's or master's)
  • Accredited Case Manager (ACM)

Physical Demands

The RN Case Manager must be able to lift/position up to 25 lbs, push/pull up to 25 lbs of force, and perform frequent sitting, moderate standing, walking, reaching, stooping, and bending.