Registered Nurse - Case Management- Case Manager

Job Title

Provides excellent patient care by assisting in the collaboration, development, implementation, revision and reporting of the case management program.

Acts as a liaison between the patient, family, nurse, physicians, multidisciplinary team and patient's healthcare benefactor to optimize outcomes.

Serves as a consultant to the healthcare team on specific patient items.

Coordinates a continuum of care for a defined population of patients from pre-admission through post discharge.

Assures that patients and families proceed efficiently through the course of hospitalization.

Job Requirements

Education and Work Experience:

• Bachelor's Degree in Nursing (BSN): Preferred
• Experience in a care management role: Preferred

Licenses/Certifications:

• Registered Nurse (RN) licensure in the state of practice: Required
• Case management certification: Preferred

Essential Functions

Leads the coordination of patient care with other disciplines within the care team, monitoring the appropriateness and timeliness of care.

Ensures the interdisciplinary care plan is consistent with the patient’s clinical course, continuing care needs and covered services by monitoring diagnostic testing, treatments and procedures, and other aspects of patient care as appropriate for acute care.

Discusses with physicians, the appropriateness of resource utilization, consultations, treatment plan, estimated length of stay, and discharge plan.

Focuses on complex patients, frequent emergency department utilizers, chronic pain patients, substance abuse patients and homeless patients.

Collaborates with acute care case managers to ensure appropriateness on ongoing care.

Coordinates the transfer of patients to tertiary centers, including the transfer of patient information required for continuity of ongoing treatment and services.

Provides oversight and collects data required for regulatory and accreditation compliance.

Manages frequent emergency department visitors by conducting a focus study review of the previous and current admissions.

Performs other job-related duties as assigned.

Organizational Requirements

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.

Adventist Health participates in E-Verify. Visit Adventist Health careers page for more information about E-Verify.