Job detail

RN Case Manager - Case Management

Licking Memorial Health Systems

#Case Management #RN #Patient Care #Healthcare Services #Critical Care #Discharge Planning #Acute Care #Emergency Department #Utilization Review

Quick overview

The RN Case Manager develops individualized, cost-effective care plans for patients ranging from newborns to geriatrics. They coordinate healthcare services, manage hospital stay status, and facilitate discharge planning and patient education.

Requirements summary

Candidates must be a graduate of an accredited nursing school and licensed in Ohio with at least 2 years of acute care clinical experience. Experience in critical care, emergency departments, or utilization review is highly desired.

professional certificateCase ManagementPatient AdvocacyCommunication SkillsPatient AssessmentComputer SkillsDischarge PlanningDisease ManagementClinical CareUtilization ReviewMedical Necessity Criteria

Job description

RN Case Manager

Position Summary

The case manager is responsible for individualized management of hospital and healthcare services necessary and appropriate to the provision of high quality, cost effective patient care. He or she works with acutely ill and/or high risk clients ranging in age from newborn to the geriatric population. The Case Manager develops collaborative, outcome-oriented plans of care for each patient, acts as a patient advocate and provides mechanisms and support to empower patients to make responsible healthcare decisions while guiding appropriate utilization of resources and services to achieve expected outcomes.

Responsibilities

Determines appropriate level of care on admission using hospital approved medical necessity criteria
Performs patient and care giver assessments to identify pertinent problems/needs
Organizes assessment data into an individual plan of care, with anticipated outcomes
Determines continued stay status
Participates in multidisciplinary rounds
Participates in patient education
Tracks and manages potential avoidable hospital days
Provides clinical information to external providers and managed care organizations
Assists in discharge planning
Assists in appeals and denials management

Requirements

Graduate of an accredited school of nursing and licensed in the state of Ohio
2 years of clinical experience in an acute care setting
Critical care/emergency department experience highly desired
Knowledge of evidenced-based practice and disease management protocols
Utilization review and or discharge planning experience preferred
Excellent verbal and written communication skills
Excellent computer skills.
LMH is accredited by DNV and TJC, and as such, may require specific annual education related to specialty certifications and standards.

Licking Memorial Health Systems is an equal opportunity employer and maintains compliance with all state, federal, and local regulations. Licking Memorial Health Systems does not discriminate against applicants because of race, color, religion, sex, sexual orientation, age, ancestry, national origin, veteran status, pregnancy, disability, marital status, or other characteristics protected by law.