- Bachelors Degree Preferred
- 1 - 2 years experience preferred
The RN Case Manager utilizes professional nursing skills to assess patient and family scenarios for clinical appropriateness for the setting and establishes plans for effective management of the continuum of care (episodic, population and physician based). Assessing, planning, intervening, advocating, educating, and reassessing are performed in a collaborative environment, in which the RN Case Manager works closely with the Clinical Staff, Social Work Case Managers, Nursing and Allied Health disciplines, hospital business/financial services, agencies across the continuum (internal and external) and payers. The key goals of the RN Case Manager include proactive, individualized planning for the patients' progress across the continuum that optimizes quality of care, utilization, cost and patient satisfaction. The RN Case Manager also participates in evaluating opportunities that address over/under utilization and optimize reimbursement across populations of patients to meet organizational strategic objectives. Requires knowledge of the behaviors, developmental stages, physical and emotional needs, life cycle changes, culture, and comfort and care appropriate to the population served. Populations served by the department are identified in the department's scope of service. QUALIFICATIONS/KNOWLEDGE/SKILLS/ABILITIES
- Graduate of an accredited school of nursing with a current Indiana ASN license required.
- Working toward BSN or Bachelor?s degree in related fields such as Health Care Administration required.
- Minimum of three years of clinical experience in the health care setting, preferably acute care hospital required. Previous Utilization Review or Case Management experience preferred. Case Management competencies must be completed successfully prior to promotion to Case Manager. Computer proficiencies to enter and retrieve data, to assemble and organize data, to use, analyze, and integrate data from diverse sources, email and calendar required.
- Use of Internet preferred.
- Previous experience with hospital information systems (STAR, MIDAS, PIM) preferred. Current American Heart Association (AHA) Health Care Provider CPR preferred or American Red Cross Professional Rescuer Certification at point of hire or must obtain AHA Health Care Provider CPR within 1st week of orientation prior to patient care required.
- Requires Licensure (or certification) is considered minimal competence unless an event of error occurs Requires knowledge of Medicare/Medicaid, insurance and regulatory guidelines Requires knowledge of medical and allied health sciences to apply criteria to the medical record with respect to patient needs for medical and health care.
- Requires knowledge of Medical terminology, levels of care, treatment modalities, and the present health care delivery system.
- Requires knowledge and understanding of the pathway concept.
- Requires knowledge of financial management Must have the ability to work in a standing position and do frequent walking, as well as frequent sitting in office setting. Must have the ability to walk for periods up to 5-6 hours per day. Must have the ability to use independent judgment and discretion. Must have the ability to juggle several assignments simultaneously and appropriately prioritize based on caseload. Must have the ability to cope successfully with diversity, complexity and to integrate seemingly unrelated data. Must have the ability and capacity to document in clear and concise fashion with appropriate grammar and vocabulary and word usage. Must have the ability to quickly, efficiently and accurately manipulate equipment such as computer keyboards, calculators, phones, etc. Must have the ability to engage in potentially stress-producing activities. Must have the ability to exhibit a high degree of skill in interpersonal relations with the ability to deal effectively on a one/one and group basis with physicians, nursing staff, administration and other hospital departments. Must have the ability to read, analyzes, and interprets common and technical journals, financial reports, and legal documents.
- Must have the ability to effectively present information. Must have the ability to define problems, collect data, establish facts and draw conclusions.
Ball Memorial Hospital - 21 months ago