Registered Nurse (RN) Case Manager

Foundation Health, LLC•Fairbanks, AK

About The Position

Provides comprehensive care coordination for assigned patients. Assesses each patient's plan of care and develops, implements, monitors, and documents resource utilization and patient progress throughout care. Coordinates options and services to meet patients' health care needs, adjusting the intensity of coordination to the patient's needs and payer requirements. Is accountable for the quality of clinical services delivered by the role holder and others, and identifies and resolves barriers that may hinder effective patient care. Fairbanks Memorial Hospital is a nonprofit facility owned by the Greater Fairbanks Community Hospital Foundation. It is a Joint Commission-accredited facility with 152 licensed beds and serves as the primary referral center for residents of Alaska's interior. The hospital describes its clinical environment as having a strong patient-to-nurse ratio and Shared Leadership Infrastructure.

Requirements

Knowledge of case management or utilization review, normally obtained through completion of a bachelor's degree in case management or health care.
Current Registered Nurse (R.N.) license in the state where the employee works.
For acute care assignments, Basic Life Support (BLS) certification.
Typically five years of clinical experience.
Working knowledge of care management, acute care and/or home care environments, community resources, and resource/utilization management.
Demonstrated critical thinking, problem-solving, effective communication, and time management skills.
Ability to work effectively in an interdisciplinary team format.
For acute care assignments, ability to work flexible hours and take rotating after-hours call.
For Foundation Registry and Travel positions, at least one year of experience in an acute care hospital and/or home care setting, including work within the past 12 months as a Case Manager in the specialty area.

Nice To Haves

CCM (Certified Case Manager) certification.

Responsibilities

Manage individual patients across the health care continuum to achieve optimal clinical, financial, operational, and satisfaction outcomes.
Lead process improvement activities for patient populations to achieve optimal clinical, financial, operational, and satisfaction outcomes.
Collaboratively develop and manage interdisciplinary patient discharge plans, and communicate plans across the continuum of care.
Evaluate the medical necessity and appropriateness of care to optimize patient outcomes.
Assess admissions and continued stays using standard criteria; identify factors that may delay discharge and facilitate their resolution.
Build collaborative relationships with physicians, payers, and other health care team members.
Collect and communicate timely, pertinent information to payers and others to fulfill utilization and regulatory requirements.
Educate internal health care team members on case management and managed care concepts and facilitate their integration into daily practice.
May supervise other staff.
Perform duties in accordance with established policies, procedures, regulatory and accreditation requirements, and applicable professional standards.
Provide customers of Foundation Health with an excellent service experience by consistently demonstrating core and leader behaviors.