Registered Nurse Case Manager (RN) - Utilization Management

Hartford Healthcare • Willimantic, CT

2d

About The Position

Provides guidance and/or direction in the management of overall discharge planning and appropriate use of hospital resources. Works under the direction of the Manager of Continuing Care and Utilization Management and in collaboration with physicians, social services, and other hospital personnel. Assesses the need for and facilitates the delivery of post hospital care for neonates, infants, pediatric, adolescent, adult and geriatric patient populations by making the necessary referrals to home care agencies or to SNF/Subacute facilities. Evaluates the appropriateness of hospital services. Ensures that patients receive the appropriate services at the appropriate time to promote quality outcomes at a reasonable cost. Maintains a program of admission and continued stay certification for Medicare, Medicaid and HMO review.

Requirements

• Three years clinical nursing required.
• Two years experience with case management, discharge planning, utilization review and/or home care required.
• Knowledge of the management of patients along the continuum of care required.
• Current license as a registered nurse in the State of Connecticut.
• Bachelor’s degree required, preferably in nursing (equivalencies may be considered based upon experience and qualifications).
• Ability to utilize Microsoft Office strongly preferred.

Nice To Haves

• Case management experience preferred.
• Certification in Case Management or Utilization Management is preferred.
• Experience with MIDAS software a plus.

Responsibilities

• Provides guidance and/or direction in the management of overall discharge planning and appropriate use of hospital resources.
• Works under the direction of the Manager of Continuing Care and Utilization Management and in collaboration with physicians, social services, and other hospital personnel.
• Assesses the need for and facilitates the delivery of post hospital care for neonates, infants, pediatric, adolescent, adult and geriatric patient populations by making the necessary referrals to home care agencies or to SNF/Subacute facilities.
• Evaluates the appropriateness of hospital services.
• Ensures that patients receive the appropriate services at the appropriate time to promote quality outcomes at a reasonable cost.
• Maintains a program of admission and continued stay certification for Medicare, Medicaid and HMO review.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees