Title: Case Manager Nurse LPN or RN
REPORTING RELATIONSHIPS:
CQO
GENERAL SUMMARY OF RESPONSIBILITIES:
Coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Team members. Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs. Enhances the quality of patient management and satisfaction, to promote continuity of care and cost-effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.
Essential Job Duties
1. Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
2. Monitors all areas of patients’ stay for effective care coordination and efficient care facilitation.
3. Remains current from a knowledge base perspective regarding reimbursement modalities, community resources, case management, psychosocial and legal issues that affect patients and providers of care.
4. Appropriately refers to high risk patients who would benefit from additional support.
5. Serves as a patient advocate. Enhances a collaborative relationship to maximize the patient’s and family’s ability to make informed decisions.
6. Demonstrates knowledge of the principles of growth and development over the lifespan and the skills necessary to provide age-appropriate care to the patient population served.
7. Organizes and participates in interdisciplinary patient care conferences to review treatment goals, optimize resource utilization, provide family education and identified post-hospital needs. Collaborates with clinical staff in the development and execution of the plan of care, and achievement of goals.
8. Coordinates with interdisciplinary care team, physicians, patients, families, post-acute providers, payors, and others in the planning of the patients’ care throughout the care continuum.
Other Job Functions:
1. Other duties as assigned
2. Knowledge of government and non-government payor practices, regulations, standards and reimbursement.
3. Knowledge of Medicare benefits and insurance processes and contracts.
4. Knowledge of accreditation standards and compliance requirements.
5. Ability to demonstrate critical thinking, appropriate prioritization and time management skills.
6. Basic computer skills with working knowledge of Microsoft Office, word-processing and spreadsheet software.
7. Excellent interpersonal, verbal and written skills in order to communicate effectively and to obtain cooperation/collaboration from hospital leadership, as well as physicians, payors and other external customers
8. Demonstrates good interpersonal skills when working or interacting with patients, their families and other staff members.
Job Qualifications:
Education:
Required: Graduate of an accredited practical nursing program,
Experience:
Required: Three years' recent clinical and/or medical office experience
Preferred: One year recent acute hospital experience. Rural health care experience word processing and database program skills;
License/Certifications:
Required: Current and Valid Nebraska RN License, LPN with 3 plus years in a health care setting
BLS for healthcare workers
Personal Skills:
Superior verbal communication skills required. Must be able to work independently with keen attention to detail. Worked
Upon hire, you must provide a copy of an Immunization Record and disclose your current influenza immunization.
All offers of employment are subject to a background check and drug screening.
EOE
