RN-Case Manager

Job TitleManages 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 their hospitalization, illness, and/or life situation. Performs other duties as assigned.ResponsibilitiesUtilization ReviewDischarge planningReadmission Reduction ParticipationPayer Communication and denial reductionCompletes assigned goals.ExperienceMinimum RequiredRN with at least one (1) year of clinical experiencePreferred/DesiredRN with 3 years of clinical experience with Case Management experience in a hospital or payer settingEducationMinimum RequiredDiploma or Associate Degree in NursingPreferred/DesiredBSN or MSNTrainingMinimum RequiredPreferred/DesiredCertified Case ManagerSpecial SkillsMinimum RequiredCritical thinking skills, communication, organization, interpersonal and computer skills. Problem solving; and governmental regulations.Preferred/DesiredCritical thinking skills, communication, organization, interpersonal and computer skills. Knowledge of payer requirements; problem solving; and governmental regulations.LicensureMinimum RequiredRNPreferred/DesiredRN;CCM;ACM