CASE MANAGER (RN/LIC) - Full Time

UHS•Reno, NV

16h

About The Position

This Case Manager/Utilization Management RN opportunity is full time, offers full benefits and a convenient schedule. We are looking for a dynamic individual who is responsible for the implementation of the case management process, which is assessment, planning, collaboration and intervention, monitoring and evaluation. Through this process, the Case Manager facilitates the patient’s care from admission to discharge. The Case Manager reviews care for level of care criteria, quality and efficacy of care and treatment, core measure interventions, and other criteria as requested. Collaborates with all members of the healthcare team to facilitate discharge planning including providing patient and family education specific to disease management and follow up care. Coordinates level of care referrals and planning with the social worker.

Requirements

Graduate from an accredited school of nursing, associate’s degree required, baccalaureate degree preferred.
Current Nevada Registered Nurse License.
Five (5) or more years of previous experience in all aspects of nursing and two (2) or more years of UR or CM experience preferred.
Current BLS certification.

Responsibilities

Performs the care management process to assess, plan and facilitate discharge planning on all patents. Documents initial assessment within 48 hours of admission.
Demonstrates competency in use of Interqual criteria to determine appropriateness and level of care of admitted and continued stay patients. Provides ongoing assessment and re-evaluation and documents appropriately.
Able to communicate with physicians regarding all aspects of patient care management including discharge planning, authorization for services and utilization of hospital and community resources. Collaborates with Medical Director to liaison with physicians on difficult and/or complex cases.
Demonstrates working knowledge of benefits and authorization for services, for various payers including Medicare, Medicaid, County, HMO’s and other commercial payers.