About the role

  • Communicates in an active, positive and effective manner to all health care team members
  • Collaborates with staff from the interprofessional health care team to improve outcomes
  • Uses a structured format for regular communication with patients and families
  • Assesses all patients timely and thoroughly
  • Participates in daily Care Coordination Rounds (CCR)
  • Supports patients and families in preventing/resolving clinical or ethical issues
  • Facilitates discharge planning activities for assigned patients
  • Maintains ownership of the discharge planning process on assigned units
  • Initiates and facilitates referrals for home health care, hospice, and durable medical equipment
  • Consults with Social Worker Case Manager to assess psychosocial needs associated with transition to alternative levels of care
  • Modifies care based on continuous evaluation of the patient's condition
  • Documents accurate assessment and interventions efficiently and effectively
  • Plans for routine discharge and elevates emergent situations
  • Performs review for medical necessity of admission, continued stay and resource use
  • Participates in denial mitigation activities to ensure appropriate reimbursement for services rendered
  • Contributes to meeting department and hospital financial target
  • Initiates evidence-based practice/performance improvement projects
  • Seeks opportunities to identify self-development needs and takes appropriate action

Requirements

  • Graduate of education program approved by the credentialing body for the required credential(s)
  • Bachelor's degree preferred
  • Three years hospital nursing clinical experience
  • Case management experience preferred
  • RN - Registered Nurse - Texas State Licensure -- Compact Licensure - Must obtain permanent Texas license within 60 days (if establishing Texas residency)
  • Demonstrates the skills and competencies necessary to safely perform the assigned job
  • Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job
  • Knowledge of Medicare, Medicaid and Managed Care requirements
  • Progressive knowledge of community resources, health care financial and payor requirements/issues, and eligibility for state, local and federal programs
  • Progressive knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement
  • Understanding of pre-acute and post-acute venues of care and post-acute community resources
  • Ability to work independently and exercise sound judgment in interactions
  • Well versed in computer skills of the entire Microsoft Office Suite

Benefits

  • Health insurance
  • 401(k) matching
  • Paid time off
  • Flexible working arrangements
  • Professional development opportunities
  • On-call duty

Job title

Case Manager, RN

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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