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Registered Nurse Case Coordinator
2 months ago
Company :
DirectEmployers
Job Overview :
POSITION SUMMARY:
This role is accountable for the development, execution, and assessment of care strategies for patients and their families/caregivers throughout the healthcare spectrum.
The incumbent will apply established standards of practice for case management by working collaboratively with healthcare providers, clinical teams, insurance plans, and external stakeholders while advocating for patients and their caregivers to ensure alignment of objectives and plans.
As a professional exemplar, the incumbent will leverage their expertise in care management to foster a cooperative professional atmosphere that enhances outcomes, engages patients/caregivers in their healthcare journey, and promotes efficient resource utilization.
The role is integral in managing readmissions, length of stay, emergency department usage, and patient/family satisfaction.KEY RESPONSIBILITIES:
Conducts or contributes to thorough evaluations of patients and their families/caregivers, considering clinical/physical needs, social determinants of health, and financial barriers affecting their health management.
(20%)Proactively identifies obstacles and assesses situations for the designated patient population, including risks for admission/readmission, external resources, and patient/family readiness to develop safe transition and care coordination plans.
(20%)Facilitates clinical care coordination among the patient, family, provider(s), and interdisciplinary team members. (25%)
Advocates for patients and families by effectively communicating with providers, interdisciplinary team members, payers, and post-acute partners to ensure optimal outcomes and care. (15%)
Utilizes knowledge of industry standards to provide relevant education to patients, families, providers, and interdisciplinary team partners on topics such as care appropriateness, documentation requirements, utilization review principles, insurance benefits and limitations, transition planning, length of stay, and resource utilization.
(10%)Actively pursues professional development opportunities through certification, mentoring, and participation in departmental or organizational committees. (5%)
Complies with the policies, procedures, rules, regulations, and requirements of healthcare facilities and other clinical environments. (5%)
QUALIFICATIONS:
Minimum Requirements:
Bachelor's Degree in Nursing
OR
Bachelor's Degree with Nursing Diploma
OR
6 years of relevant experience in lieu of a degree
3 years in a clinical nursing position
Current State RN licensure or current multistate licensure through the enhanced Nurse Licensure Compact (eNLC).
Professional Certification within 5 years of employment start date. Incumbents in role as of a specified date have until a later date to obtain
Strong critical thinking and problem-solving abilities
Adaptability and flexibility to change
Excellent communication and collaboration skills with the ability to adjust style based on the audience (providers, peers, clinical team members, patients, families)
CPR certification from the American Heart Association
Background clearance certificates as required by law
Preferred Qualifications:
Nationally recognized Case Management Certification
Knowledge of transition planning and familiarity with community and facility resources
Understanding of motivational interviewing techniques
Licenses or Certifications:
Required:
None
Preferred:
ACM Certification (Accredited Case Manager) from the American Case Management Association
Case Management certification from the American Board of Occupational Health Nurses (ABOHN) and Certified Case Manager (CCM)
Certification from the Commission for Case Manager Certification (CCMC)
Disclaimer:
- The job description is intended to outline the general nature and essential duties and responsibilities of the position. It may not encompass all duties, responsibilities, and qualifications required for the role.
Compliance Requirement:
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity
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