- Utilization Management
- Case Management
- Management Experience
- Hospital Experience
The Case Manager is responsible for utilizing advanced practice nursing skills in the assessment, education, and coordination of care for an identified group of patients. Collaborates and consults with the multi-disciplinary team, including but not limited to Physicians, Nursing, Ancillary, Professional, Technical, other clinical and/or department team members along with patients and families to ensure safe and effective coordination of care. Assesses, coordinates, develops and implements individualized care plans utilizing evidence-based tools for risk stratification to ensure delivery of safe, high quality, efficient, and cost-effective care. Performs Utilization Review functions using standardized practice tools to guide billing and level of care practices. Assures the delivery of concurrent and post-hospital care through initiation of referrals, coordination of resource utilization, and evaluation of post-acute care services. Effectively manage the post-acute referral process through the continuum of care to ensure safe discharge. Participate in performance improvement projects/processes and other duties as assigned.
CA RN license required, BSN required, MSN preferred. Minimum of three years of acute hospital experience; or the equivalent of education and experience. Recent experience in case management, utilization management, or discharge planning.
ER Experience preferred.
Team leading or management experience. Self-directed, assertive and creative in problem solving, systems planning and patient care management in a high volume work environment. Demonstrates resourcefulness, effective written and oral communication, diplomacy, organizational, and analytical skills. Ability to work effectively and collaboratively with interdisciplinary teams. Basic working knowledge of a large University teaching hospital; its purpose and functions