POSITION SUMMARY |
MINIMUM QUALIFICATIONS AND REQUIREMENTS
- The ED / Access RN Case Manager facilitates effective utilization of appropriate health services throughout the continuum of care. Performs pre-admission, concurrent admission and retrospecitive admission clinical review for medical necessity and the appropriate level of care. Assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet an individual’s health needs throughout the continuum in various settings through communication and available resources to promote quality cost-effective outcomes. Communicates with physicians, payers and others to promote fiscal responsibility and effective use of available resources to decrease fragmentation of care across settings.
- Licenses and Certifications Required
- Current licensure as a RN in the state of North Dakota required. Certification in case management desirable. BLS certification required.
- Educational Requirements
- Experience Requirements
- Must have three (3) years of professional experience in an acute care or ETC setting. Prior case management/utilization management experience desirable.
- Special Skills or Training Requirements
- Demonstrated advanced communication and interpersonal skills with all levels of internal and external customers, including but not limited to medical staff, patients and families, clinical personnel, support and technical staff, outside agencies, and members of the community. Basic understanding of reimbursement issues and Diagnostic Related Groups (DRGs), and personal computer skills using email, word processing, etc.
Trinity Health - 20 months ago