Job detail

Case manager support

Premier Health

#Registered Nurse #Interdisciplinary Team #Patient Assessment #Care Coordination #Performance Improvement #Case Manager #Resource Allocation #Atrium Medical Center #Utilization Management

Quick overview

The Case Manager-Support, a registered nurse, is responsible for individualized patient assessment, care coordination, and transition planning to optimize outcomes, length of stay, and resource utilization. This role involves facilitating interdisciplinary team collaboration and acting as a liaison between the patient, physician, payor, and family regarding care coordination and transitional needs.

Requirements summary

Candidates must possess a BSN and a valid Ohio Registered Nurse license, along with a minimum of three years of relevant clinical experience within the last five years. Preferred expertise includes healthcare reimbursement, transition planning, case management, and knowledge of specific clinical guidelines and performance improvement processes.

bachelor degreeRegistered NurseNegotiationPatient AssessmentCare CoordinationComputer SkillsInterdisciplinary Team CollaborationConflict ResolutionResource AllocationTransition PlanningUtilization ManagementAcute Care NursingHealthcare ReimbursementAssertive CommunicationMilliman GuidelinesClinical Outcome Data AnalysisInterQual ISD-A

Job description

General Summary

Department:
Integrated
CARE
Management
Shift:
Support (Prn)/Varied
HOURS/24
HOURS
PER
MONTH
Facility: Atrium Medical Center The Case Manager-Support is a registered nurse responsible for individualized patient assessment and care coordination, and transition planning to promote maximal outcomes in relation to appropriate length of stay, effective use of resources and established guidelines of care. Additional responsibilities include facilitation of interdisciplinary team collaboration, liaison between the patient, physician, payor, family/significant others in regards to care coordination and transitional care needs. This position requires expertise in acute care nursing, healthcare reimbursement requirements, clinical outcome data analysis, utilization management, transition planning and process, resource allocation, team management and communication skills. Promotes care coordination and effective utilization of resources through the assessment of patient care needs during the hospitalization and across the health care continuum. Success is measured against achievement of targeted goals and outcomes as generated by defined expectations through care team collaboration.

Education

BSN required.

Licensure

Registered Nurse with valid Ohio license.

Certification

Certification in area of clinical specialty preferred.

Experience

Minimum of three years of relevant clinical experience in area of patient population within last five years. Expertise in healthcare reimbursement, transition planning and case management preferred. Experience with a clinical documentation management program preferred, knowledge of performance improvement process preferred.
Skills/Other: Exemplary interpersonal skills as demonstrated by the ability to develop and maintain rapport with physicians and Integrated Care Team members. Negotiation skills, conflict resolution skills and assertive communication skills required. Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required. Basic computer skills required.