RN, Case Manager/Full Time (Northside Medical Center)
Northside Medical Center - Warren, OH

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  • RN, Case Manager/Full Time (Northside Medical Center)
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1259111

Description

JOB SUMMARY

Responsible to ValleyCare Health System for supporting the corporate mission, vision and values.

Responsible to Case Management for

applying knowledge of the expected clinical trajectory, available resources, and relevant standards of care in anticipating patient needs and coordinating the plan of care. Efficient utilization of health care resources and timely transition to the next appropriate level of care are a priority. Case Management at NMC is an interdisciplinary approach to managing patient throughput in a fiscally responsible manner to achieve optimal outcomes.

RESPONSIBILITIES AND MAJOR DUTIES

Coordinates clinical care services to ensure consistent standards of care and appropriate use of resources; and to prevent unnecessary delays.

Facilitates psychosocial care coordination to ensure timely identification and resolution of psychosocial issues impacting patient throughput.

Effectively manages resource utilization to ensure efficiency and appropriate reimbursement.

Proactively initiates discharge planning and placement to facilitate timely patient transition to the next level of care.

Collaborates with medical staff members to promote complete and accurate physician documentation in the medical record.

Integrates clinical, financial, ethical, compliance, and other variables in complex decision making.

Actively participates in projects designed to reduce costs, capture lost revenue, or enhance efficiency.

Educates medical staff and others regarding documentation, medical necessity, available resources, and

reimbursement issues.

Develops and maintains a working knowledge of current reimbursement methods and regulations pertinent to RN case management practice.

Performs other related duties as assigned.

Qualifications

EDUCATION AND EXPERIENCE

Associate degree or diploma in nursing from a college or technical school required.

Bachelor’s degree in nursing strongly preferred. Requires up to five year’s experience on this or related jobs in a hospital or healthcare facility to develop the judgement necessary to make appropriate decisions and to handle emergency situations.

LICENSURE, REGISTRATION AND/OR CERTIFICATION

Current

Ohio

license as a registered nurse by the Ohio Board of Nursing required. Certification in case management strongly preferred.

ESSENTIAL KNOWLEDGE AND SKILLS

Broad knowledge in professional area and in statistics, nursing, and other related departments.

Knowledge of regulatory, legislative and JCAHO standards related to case management.

LANGUAGE AND MATH SKILLS

Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, and decimals.

Ability to compute rate, ratio, and percent, and to draw and interpret bar graphs. Ability to read, analyze and interpret professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

COMPUTER OPERATIONS

Proficient in general office computer skills including electronic mail, word processing, routine databases, basic spreadsheets and work with graphics.

Accesses online resources and insurance provider websites.

Job

Case Management / Utilization Review

Primary Location

OH-Warren (Youngstown region)

Organization

Northside Medical Center

Working Location

Northside Medical Center Youngstown Ohio

Shift

Day Shift

Forecasted paid hours per shift

8

Forecasted hours per pay week

80

Employee Status

Full-time

Community Health Systems - 22 months ago - save job - copy to clipboard
About this company
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Northside Medical Center is staffed with a team of dedicated medical professionals who are experts in their fields of study. Using the...