Case Management Nurse – Case Manager Job Description Template
Our company is looking for a Case Management Nurse – Case Manager to join our team.
Responsibilities:
- Educating the member/family/caregiver about the care management process and evaluating their understanding of the process;
- May advise patients on health maintenance and disease prevention or provide case management. Licensing or registration required;
- Documenting members’ care management plans and on-going activities;
- Identifying member needs, current services, and available resources, then connecting the member to services and resources to meet established goals;
- Administer nursing care to ill, injured, convalescent, or disabled patients;
- Identifying and addressing member risk factors and/or obstacles to care;
- Excellent communication and organization skills and ability to perform identified nursing services;
- Assess patient health problems and needs, develop and implement nursing care plans, and maintain medical records;
- Developing a member-focused care management plan;
- Screening members and/or population for healthcare needs;
- Participate in weekly case review to learn and share opportunities to improve outcomes.
Requirements:
- Other requirements to be determined by our client facility;
- Eighteen months of recent experience in an Acute Care Case Manager setting;
- BLS certification;
- Understanding of the third party denial and appeal process is preferred;
- Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred;
- Associate’s Degree in Nursing required. New ASN RNs hired after January 1, 2013, will be required to complete their BSN within 5 years of hire date;
- Ability to comprehend third party contractual arrangements is preferred;
- Attend department huddles/rounds to determine daily care plans and anticipated discharge needs of case load;
- Professional Development Opportunities;
- Arrange all new hemodialysis cases;
- Experienced;
- Collaborate with patient’s care team to assist with hospital to hospital transfer;
- Valid Nursing License in state of IL;
- Determine the complexity of patient’s discharge needs to anticipate and coordinate the next level of care;
- Have knowledge of case load to readily discuss daily care plans and anticipated discharge needs.