RN Case Manager

Job Title

Weekend Coverage: 5 hours for one Saturday each month; take 5 hours off on one day of the week

Job Summary

Under general supervision is responsible for the ongoing development, implementation, and evaluation of processes of the CWHS Case Management Plan. The Case Management function is a highly collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client’s/patient’s health and human service’s needs. The RN Case Manager provides advocacy, communication, collaboration, resource management, and education to interdisciplinary team members of CWHS. Effective allocation of the hospital’s resources while encouraging provision of high-quality patient care is essential in this role. Is cognizant of regulations and policies of all review organizations relating to billing of the fiscal intermediaries and implements processes and changes to meet the Federal/State regulations.

Qualifications – License, Education and/or Experience Required

• Bachelor’s Degree in nursing (Master’s degree preferred) with at least three (3) years of clinical experience in a hospital setting and at least five (5) years of case management experience in a hospital setting
• Certification in case management (preferred) or willingness to obtain within two (2) years of employment
• Current unrestricted Registered Nurse license in the State of Colorado (required)
• Current BLS

Essential Functions

• Maintain and improve the case management system using ongoing interaction with patients, physicians, and other health providers to meet designated clinical, operational, and financial outcomes for aggregate patient populations.
• Ability to document Case Management plans in a clear and concise manner.
• Assist physicians, patients, families, staff and payers in providing care for patient populations that is appropriate, effective, and cost efficient.
• Attend and actively participate in all departmental and interdepartmental meeting relative to Case Management/Social Services functions.
• Collaborates with payers and review organizations to ensure proper utilization of patient care resources.
• Documents clearly and concisely all contacts and information of the patient’s case management process appropriately.
• Educates physicians and staff regarding appropriate level of care/utilization issues.
• Maintains current knowledge of Case Management/Social Services, discharge planning, and nursing issues through continuing education.
• Suggests and introduces new methods and techniques.
• Participates in professional activities in order to continue their professional development and contribute to that of the profession.
• Knowledge of the continuum of care, discharge planning and utilization processes.