Registered Nurse - Case Manager (NE)

Overview

Responsibilities

• Job Summary Guides care coordination for high risk acute care patients, and facilitate the discharge plan for patients with medically complex post-acute care needs.
• Analyzes medical records to determine legitimacy of admission, treatment, and length of stay in acute setting in accordance with patient needs, regulatory standards and insurance company guidelines.
• Advocates for patients/families and liaisons with key team member to ensure that patient healthcare needs are being addressed.
• Collaborates with physicians and assists in the facilitation of healthcare resources to ensure services and care are delivered in a timely manner.
• The RN Case Manager works in collaboration with patients, providers, and key stakeholders in coordinating health services and referrals to assist with ensuring safe discharge.
• Essential Functions Collaborates with patient/significant others as well as other members of the health care team in determining the appropriate level of care, utilization of resources and length of stay (utilizing electronic admission and discharge criteria program and physician input).
• Communicates with stakeholders, appropriate health care related information, both verbally and in written form, to ensure timely coordination care and services for patients receiving inpatient care.
• Identified point of contact for managing transitions of care.
• Reevaluates transition of care needs daily and coordinates transition to next level of case management or care coordination services.
• Performs concurrent review of patient treatment plans in accordance with the hospital policies and third party reimbursement systems.
• Assists in the maintenance of department logs and databases, department statistics, and utilization review documents according to hospital policy and state/ federal regulations.
• Performs other duties as assigned Education Bachelor's Degree in Nursing or healthcare related field. - Preferred Associate's Degree in Nursing from an accredited NLN/CCNE institution, or diploma from an accredited NLN/ACEN institution. - Required Experience 3 years clinical experience in a hospital setting. - Required 5 years as an RN in Case Management - Preferred 7 years as a Registered Nurse (RN) - Preferred Other Experience in an outpatient clinical setting working with PCP, Home Health or Rehab - Preferred Licenses and Certifications Certification in Case Management - Preferred Nursing\RN - Registered Nurse - State Licensure And/Or Compact State Licensure Current RN (AZ or State Compact Licensure) - Required