Complex Care - Registered Nurse Case Manager - Full Time - Experience Required

Henry Ford Hospital•Detroit, MI

23d•Onsite

About The Position

The Case Manager-RN plays a pivotal role in coordinating comprehensive patient care, ensuring seamless transitions between care levels. This position requires strong clinical judgment, excellent communication skills, and a deep understanding of healthcare systems. The Case Manager-RN will collaborate closely with patients, families, healthcare providers, and community resources to optimize patient outcomes and promote efficient resource utilization. By joining our team as a Case Manager-RN, you will have the opportunity to make a significant impact on the lives of patients and their families. Your expertise in clinical care, discharge planning, and quality improvement will be instrumental in ensuring that patients receive the highest quality care possible.

Requirements

Education: Bachelor's degree in Nursing (BSN) is preferred.
Associate's degree in Nursing (ADN) with at least two years of acute care case management experience is acceptable.
ADN candidates must enroll in an accredited BSN program within three years of hire and complete it within five years.
Experience: Minimum of three years of recent acute care nursing experience.
Certifications: Certification in Case Management (CCM) by the Commission for Case Management Certification or Accredited Case Manager (ACM) by the American Case Management Association is required within one year of hire.
Strong clinical knowledge and understanding of medical literature and research methodology.
Familiarity with financial and reimbursement issues in healthcare.
Excellent communication and interpersonal skills, including the ability to collaborate effectively with diverse teams.
Strong organizational and time management skills.
Proficiency with computers, electronic health records (EHR), database systems, and utilization review/case management documentation systems.
Demonstrated ability to think critically, solve problems creatively, and plan effectively.
Self-direction, flexibility, and the ability to work in a fast-paced environment.
Registered Nurse (RN) with a valid, unrestricted State of Michigan license.
Adherence to Henry Ford Health's Customer Service Policy and standards.
Self-direction and commitment to teamwork.
Initiative and willingness to learn.
Openness to new experiences and respect for diversity.
Demonstrated customer service values.

Nice To Haves

Prior case management experience is highly preferred.
Knowledge of CMS, commercial payer requirements, and hospital financial/reimbursement processes is desirable.

Responsibilities

Clinical Care Coordination: Conduct comprehensive patient assessments to identify individualized needs and develop personalized care plans.
Collaborate with the healthcare team to ensure timely and appropriate interventions, including specialty consultations and referrals.
Monitor patient progress, identify potential barriers to care, and implement strategies to address them proactively.
Facilitate patient education and support to empower patients and families in their healthcare decisions.
Discharge Planning: Develop and implement comprehensive discharge plans that address the patient's physical, social, and financial needs.
Coordinate with community resources and post-acute care providers to ensure a smooth transition of care.
Advocate for patients' rights and ensure access to necessary services and support.
Quality Improvement: Analyze patient outcomes and identify opportunities for improvement in care processes.
Participate in quality improvement initiatives and contribute to the development of best practices.
Stay updated on relevant regulations, guidelines, and industry trends to ensure compliance and optimize care delivery.
Interdisciplinary Collaboration: Collaborate effectively with physicians, nurses, social workers, therapists, and other healthcare professionals to deliver coordinated care.
Facilitate communication and information sharing among team members to ensure optimal patient outcomes.
Build strong relationships with community partners to support patient needs beyond the hospital setting.