Case Manager

General Summary/Responsibilities

STATUS: Full-Time / 80h per pay period

Shifts: 0830-1700

Facility: Miami Valley Hospital South

The Case Manager is a registered nurse responsible for individualized patient assessment and care coordination, and transition planning to promote maximal outcomes in relation to appropriate length of stay, effective use of resources and established guidelines of care. Additional responsibilities include facilitation of interdisciplinary team collaboration, liaison between the patient, physician, payor, family/significant others in regards to care coordination and transitional care needs. This position requires expertise in acute care nursing, healthcare reimbursement requirements, clinical outcome data analysis, utilization management, transition planning and process, resource allocation, team management and communication skills.

Promotes care coordination and effective utilization of resources through the assessment of patient care needs during the hospitalization and across the health care continuum. Success is measured against achievement of targeted goals and outcomes as generated by defined expectations through care team collaboration.

Education

BSN Required

Licensure/Certification/Registration

• Valid RN license with the State of Ohio
• Certification in area of clinical specialty (case management, neuro, critical care, rehab) preferred

Experience

Minimum of three years of hospital RN experience within the last five years required. Experience with clinical documentation management program preferred. Expertise in healthcare reimbursement, discharge planning and case management preferred

Knowledge/Skills

• Exemplary interpersonal skills as demonstrated by the ability to develop and maintain rapport with physicians and Integrative Care Team members.
• Negotiation skills, conflict resolution skills and assertive communication skills required.
• Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred,
• Knowledge of Microsoft Office is required