RN Care/Case Manager - Per Diem/As Needed - Days

Gaylord Specialty Healthcare is a health system dedicated exclusively to medical rehabilitation. We provide inpatient and outpatient care for people at every point in their journey from illness or injury to the most advanced state of recovery they can achieve. Job Summary As a Care Manager, you coordinate all health care services required for a multidisciplinary team approach to managing designated patient populations. You initiate and develop discharge plans, assess quality and cost‑efficient care, evaluate overall plan effectiveness, and provide the link between provider, payer, physician and community stakeholders in the transition of patient care. Essential Duties and Responsibilities Assures and facilitates appropriate and efficient utilization of hospital services, using nationally recognized criteria to determine medical necessity for LTACH level of care. Provides clinical information to managed care companies promptly and prevents denials through proactive interventions. Performs comprehensive assessments and reassessments of the patient’s condition and discharge planning needs, addressing psychosocial, physical, educational, cultural aspects, and social determinants of health. Collaborates with other disciplines, initiates referrals, and acts as the principal communicator to patients, families and external case managers regarding insurance benefits, treatment plans, progress, length of stay and discharge plans. Develops and revises individualized discharge plans, evaluates overall plan effectiveness, and involves patients and families in goal formulation. Meets monthly goals for length‑of‑stay management and maintains compliance with Medicare requirements, transfer notes, post‑discharge phone calls and audit functions. Portrays a professional demeanor reflective of ICARE values to all stakeholders. Understands level‑of‑care criteria and reimbursement factors for home care, rehabilitation, residential treatment and long‑term care; seeks alternatives to facilitate discharge planning. Provides patients and families support and information about their current disability. Educates and supports hospital staff regarding community resources, managed care issues or payer issues. Demonstrates flexibility, organization and functional capability under stressful situations; utilizes critical thinking and sound judgment in priority setting and delegation. Practices autonomously, consistently with evidence‑based standards, and pursues personal and professional growth. Qualifications ASN required; BSN preferred. Minimum of 2 years of RN experience required. Clinical experience in an acute or long‑term acute care hospital or in home or long‑term care preferred. Case management experience preferred. Current CT RN license required. Professional certification in case management or a clinical specialty preferred. Work Schedule: Per Diem/As Needed, weekdays. We Are An Equal Opportunity Employer – M/F/D/V #J-18808-Ljbffr