The Nurse Case Manager provides utilization management, care coordination and discharge planning for an assigned patient case load. This role is patient-focused, outcome-oriented and based on a general and speciality professional standards, and functions within a multidisciplinary practice model.
Conducts concurrent daily chart review, investigating patient history, symptoms, clinical status, and treatment utilizing Interqual ISD criteria as a tool to determine a patient's severity of illness and the intensity of service.
Works with multidisciplinary team to develop treatment plans, including contingency plans.
Leads daily case management rounds on assigned unit. Participates in house staff rounds.
Provides necessary information to appropriate organization to obtain continued stay certification; assesses payers' and referring physicians' needs in regard to content and frequency of communications.
Facilitates early referrals to social work, rehab services, patient advocacy, and quality management as needed.
Required Qualifications:Associate's degree required in Nursing. Bachelor's degree preferred in Nursing
License required: Nursing License
1-3 years related work experience required.
Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.
Preferred Qualifications:Certified Case Manager.
Previous clinical nursing experience and/or case management experience.
Competencies:Written Communications: Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers.
Oral Communications: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.
Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.
Team Work: Ability to lead and direct multiple collaborative teams for large projects or groups both internal and external to the Medical Center and across functional areas. Results have significant implications for the management and operations of the organization.
Customer Service: Ability to provide a high level of customer service and staff training to meet customer service standards and expectations for the assigned unit(s). Resolves service issues in the assigned unit(s) in a timely and respectful manner.
Age based Competencies:
Employees in this job must be competent to provide patient care to the following age groups: Neonatal:Birth to 6 months, Young adult: 16-30 years, Middle Age: 30 - 60 years, Elderly: 60 -.
Physical Nature of the Job:
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally