Job at a glance
The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions.
Accurate medical necessity screening and submission for Physician Advisor review, Care coordination & Transition planning assessment and reassessment Implementation or oversight of implementation of the transition plan Leading and facilitating multi-disciplinary patient care conferences and managing concurrent disputes Identifying and referring complex patients to Social Work Services Other duties as assigned Required: Education: Graduate of an accredited school of nursing Experience: 2 years of acute hospital patient care experience Licensure/Certification: RN.
Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy. Active RN license for state(s) covered Preferred: Education: Academic degree in nursing (bachelor's or master's) Experience: Acute hospital case management experience Licensure/Certification: Accredited Case Manager (ACM)