Nurse Case Manager- Complex Care (Onsite) (Registered Nurse)

ChenMed•Hiawassee, GA

1d•Onsite

About The Position

We are a rapidly expanding healthcare provider focused on transforming healthcare for seniors. We are seeking innovative and entrepreneurial-minded individuals to join our team as Case Managers. The Case Manager is responsible for enhancing the quality of patient management and satisfaction, promoting continuity of care and cost effectiveness through the integration of case management, utilization review, and discharge planning. This role adheres to strict departmental goals, regulatory compliance, and quality patient care standards.

Requirements

Associate degree in Nursing required.
A minimum of 2 years’ clinical work experience required.
Thorough knowledge of case management principles, healthcare management, and reimbursement.
Strong written and verbal communication skills; presentation skills.
Ability to convey medical terms and treatment plans so they are understood by patients and their caregivers.
Excellent organizational and time management skills.
Astute problem-solving skills with the ability to multi-task.
Compassionate and empathetic demeanor with the ability to work both independently and in a group/team environment.
General computer knowledge and effective Microsoft Office Products (PowerPoint, Excel, Word and Outlook) skills, plus the ability to use a variety of other word-processing, spreadsheet, database, e-mail and presentation software.
Ability and willingness to travel locally, regionally and/or nationwide up to 10% of the time.
Spoken and written fluency in English.
Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
Critical thinking skills required.
Ability to work autonomously is required.
Knowledge of nursing and case management theory and practice.
Knowledge of patient care charts and patient histories.
Knowledge of clinical and social services documentation procedures and standards.
Knowledge of community health services and social services support agencies and networks.
Organizing and coordinating skills.
Ability to communicate technical information to non-technical personnel.
Proficient in Microsoft Office Suite products including Excel, Word, PowerPoint, and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software.
This job requires use and exercise of independent judgment.
A valid, active Registered Nurse (RN) license in State of employment required.
This position requires possession and maintenance of a current, valid driver’s license.

Nice To Haves

Bachelor’s Degree in nursing (BSN) or RN with bachelor’s degree in home in a related clinical field preferred.
A minimum of 1 year of case management experience in community case management experience highly desired.
Certified Case Manager certification is preferred.
Certification through the Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired.
Bilingual a plus.

Responsibilities

Coordinates the integration of social services/case management functions into patient care, discharge, and home planning processes with other departments, external service organizations, agencies, and healthcare facilities.
Conducts concurrent medical record review using specific indicators and criteria.
Acts as a patient advocate, investigating and reporting adverse occurrences and performing staff education related to resource utilization, discharge planning, and psychosocial aspects of healthcare.
Promotes effective and efficient utilization of clinical resources and mobilizes resources to assist in achieving desired clinical outcomes within a specific timeframe.
Conducts review for appropriate utilization of services from admission through discharge.
Evaluates patient satisfaction and quality of care provided.
Communicates with physicians at regular intervals throughout hospitalization and develops an effective working relationship.
Assists physicians in maintaining appropriate cost, case, and desired patient outcomes.
Coordinates the provision of social services to patients, families, and significant others.
Completes expanded assessment of patients and family needs at the time of admission.
Completes psychosocial assessment.
Refers cases where patients and/or family would benefit from counseling to complete complex discharge plans to a social worker.
Serves as a patient advocate, enhancing collaborative relationships to maximize patient and family decision-making.
Facilitates interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education, and identify post-hospital needs.
Directs and participates in the development and implementation of patient care policies and protocols.
Performs other duties as assigned and modified at manager’s discretion.
Ability to monitor, assess, and record patients’ progress and adjust and plan accordingly.
Ability to plan, implement, and evaluate individual patient care plans.
Ability to work as oversight for License Practical Nurse (LPN) for initial assessments, plan of care, and supervisory visits including proper discharge of a patient from case management.