RN Case Manager
4 weeks ago
Serves as a key member of the Case Management Team, applying RN clinical expertise and medical appropriateness to care coordination and discharge planning. Facilitates the delivery of quality, cost-effective, patient-centered care from pre-admission through post-discharge timeframe. Ensures care is designed to meet individualized patient outcomes.
Key Responsibilities- Contributes to the achievement of established department goals and objectives, adhering to department policies, procedures, quality standards, and safety standards.
- Collaborates with the multidisciplinary healthcare team to develop and coordinate the plan of care.
- Communicates with patients, families, and/or significant others, healthcare teams, external case managers, community resources, and facilities to address appropriate issues and patient/family goals.
- Demonstrates the ability to develop a plan of care that addresses needs across the continuum, identifies specific services to be provided, and includes the family/care-giver in the plan of care.
- Evaluates and documents the patient's response to the plan of care and achievement of outcomes, making recommendations for modifications as indicated.
- Maintains knowledge of regulatory agencies' requirements, necessary criteria for admission to various care settings, and Medicare's/Medicaid's reimbursement methods for different levels of care.
- Manages a caseload of patients, identifying essential resources needed to implement the plan of care.
- Manages own professional growth in the area of managed care, care management, other healthcare, financial trends, clinical practice, and research.
- Participates in Performance and Service Improvement teams, assisting in program evaluation through customer service surveys, LOS data analysis, charge/discharge data, comparison to state averages, and best practice/benchmark data.
- Performs a comprehensive assessment in collaboration with the interdisciplinary team to identify patient-specific problems and needs related to diagnosis, treatment, including psychosocial and financial concerns as well as medical.
- Associate's degree in Nursing (ADN) required
- Bachelor's degree in Nursing (BSN) preferred
- 2-3 years of clinical experience required
- 1-2 years case management experience preferred
- RN - Registered Nurse - State Licensure and/or Compact State Licensure in the District of Columbia or Maryland depending on work location required
- CCM - Certified Case Manager preferred
- Ability to use computer to enter and retrieve data
- Working knowledge of Microsoft Word, Excel, and PowerPoint applications
- Effective verbal and written communication skills
- Must be able to run and analyze departmental productivity reports
- Excellent interpersonal skills required
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