SSH-CASE MANAGER-RN BSN

Sparrow•Lansing, MI

1d•Onsite

About The Position

The Case Manager manages cases in collaboration with the health care team, evaluating appropriateness for admission to Sparrow Specialty Hospital and assessing, planning, coordinating, monitoring, and evaluating services needed to address patients’ psychosocial, resource, and continuing health care needs in a financially responsible manner. The role plans, organizes, and supervises Case Management services. The position supports referrals and admissions, conducts admission and continued-stay reviews, communicates with physicians, discharge-planning case managers, payers, patients, families, and other departments, and documents case decisions and patient information. It also participates in utilization review, patient-throughput initiatives, education, quality improvement, accreditation, and activities supporting the department and hospital mission. Travel may be necessary.

Requirements

Registered Nurse with a current Michigan license.
Minimum of five years of recent acute care experience.
Case Management experience.
Bachelor’s degree in nursing.
Demonstrated excellent clinical knowledge, skills, and judgment.
Demonstrated excellent communication skills, including relationship building, negotiation, persuasion, marketing, and advocacy.

Nice To Haves

Certified Case Manager certification preferred.
BLS certification preferred.
Master’s degree preferred.

Responsibilities

Assist referral hospitals in identifying potential Sparrow Specialty Hospital admissions.
Educate and market referral hospitals regarding Sparrow Specialty Hospital programs and services.
Clinically screen, evaluate, and recommend patients at referral hospitals for admission.
Assist with collecting financial information to assess candidates’ financial appropriateness for admission.
Perform admitting functions and may perform discharge functions.
Perform admission and continued-stay reviews; apply SI/IS/DS criteria; determine case actions; communicate appropriate length of stay to physicians and discharge-planning case managers; document case rationales; and determine the next review date.
Refer appropriate cases to physician reviewers on the Utilization Review Committee and communicate effectively with them.
Participate in the Utilization Review Committee.
Communicate with third-party payers and reviewers, documenting reviewer decisions, length of stay, and next review dates.
Communicate billing and patient-status information to other Health System departments.
Participate in health system meetings and initiatives supporting patient throughput, such as bed meetings and critical care rounds.
Provide clear, concise, timely written documentation in patient medical records and departmental records.
Communicate professionally, diplomatically, and empathetically with patients, families, health care team members, and others.
Participate in activities that support and advance the department and Sparrow Specialty Hospital mission, vision, and goals.
Provide or arrange education for patients, families, physicians, and other health care team members to enhance care or improve department outcomes and operations.
Use the Performance Evaluation System to identify goals, establish action plans, and document steps taken to improve job performance.
Participate in planning, implementing, and evaluating quality improvement activities within the department, health system, and/or community.
Travel as necessary.
Participate in the accreditation process.
Comply with infection control standards, including Standard/Universal Precautions, hand hygiene, and use of personal protective equipment.
Maintain a healthy work environment by following the “Commitment to my Co-workers” principles.
Meet mandatory job-related requirements, including staff meetings, in-services, annual competencies, and TB testing.
Maintain knowledge of current trends in the area of expertise and provide evidence of current competencies.
Perform other duties as assigned.