RN-Case Manager

Job Summary

Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during hospitalization, illness, and/or life situation. Performs other duties as assigned.

• Utilization Review
• Discharge planning
• Readmission Reduction Participation
• Payer Communication and denial reduction
• Completes assigned goals

• Minimum
  
  Required:
  
  RN with at least one (1) year of clinical experience
• Preferred/Desired: RN with 3 years of clinical experience with Case Management experience in a hospital or payer setting

• Minimum
  
  Required:
  
  Diploma or Associate Degree in Nursing
• Preferred/Desired: BSN or MSN

• Minimum
  
  Required:
  
  Certified Case Manager

• Critical thinking skills, communication, organization, interpersonal and computer skills. Problem solving; and governmental regulations.
• Preferred/Desired:
  Knowledge of payer requirements; problem solving; and governmental regulations.

• Minimum
  
  Required:
  
  RN
• Preferred/Desired: RN;
  
  CCM;
  
  ACM

• Entry level

• Other

• Health Care Provider

• Hospitals and Health Care