RN - Case Manager

Care Manager

Under general supervision, responsible for the ongoing development, implementation, and evaluation of processes of the 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 health and human services needs. The RN Case Manager provides advocacy, communication, collaboration, resource management, and education to interdisciplinary team members. Effective allocation of resources while encouraging the provision of high-quality patient care is essential in this role. Familiar with regulations and policies relating to billing and implements processes and changes to meet Federal and State regulations. Maintain and improve the case management system through ongoing interaction with patients, physicians, and other health providers to achieve designated clinical, operational, and financial outcomes. Ability to document Case Management plans in a clear and concise manner. Assist physicians, patients, families, and staff in providing care that is appropriate, effective, and cost-efficient. Attend and actively participate in all departmental meetings related to Case Management functions. Collaborate with payers and review organizations to ensure proper utilization of patient care resources. Document all contacts and information of the patient's case management process clearly and concisely. Educate physicians and staff regarding appropriate levels of care and utilization issues. Maintain current knowledge of Case Management, discharge planning, and nursing issues through continuing education. Suggest and introduce new methods and techniques. Participate in professional activities to continue professional development and contribute to the profession. Knowledge of the continuum of care, discharge planning, and utilization processes.