Clinical Case Manager
4 weeks ago
Job Summary
The Clinical Case Manager at Renown Health plays a critical role in ensuring the delivery of high-quality, cost-effective care to patients. This position is responsible for assessing, planning, implementing, and evaluating options for care and services to meet the individual needs of patients and facilitate timely and appropriate discharge.
Key Responsibilities
- Collaborate with the interdisciplinary team to promote case management activities throughout the health continuum.
- Assess pre-morbid health status, current medical condition, and post-acute needs to determine the most appropriate level of care.
- Work closely with Utilization Management RNs to ensure services are delivered at the most appropriate level of care and to secure reimbursement from payers.
- Act as a consultant and educator on matters related to alternative levels of care and managed care issues.
- Provide information on certified LOS and reimbursement issues to physicians as needed to ensure timely disposition of patients to the next level of care.
- Monitor and document progress of the plan, making revisions as needed, to ensure a smooth transition to the next level of care at the time of discharge.
Requirements
- Must have working-level knowledge of the English language, including reading, writing, and speaking English.
- Appropriate education to obtain and maintain State of Nevada Registered Nurse licensure.
- One year experience preferred as an RN, with Case Management, Post-Acute experience, and/or UR/QA experience preferred.
- Ability to obtain and maintain a State of Nevada Registered Nurse license.
- National Certification (i.e. Case Management (CCM), Professional Utilization Reviewer (CPUR), or Managed Care (NMCC)) preferred.
Working Conditions
This position does not provide patient care. The Case Manager must respect beliefs and values while advocating for the client's right to self-determination and to make informed choices.
Disclaimer
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
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