Registered Nurse (RN) Case Manager - Primary Care Clinic

Foundation Health, LLC•Fairbanks, AK

9d•$38 - $63•Onsite

About The Position

The RN Case Manager plays a key role in delivering coordinated, patient-centered care within Primary Care by partnering with providers, clinical staff, patients, and families to identify needs and develop individualized care plans. This position supports patients throughout their healthcare journey by coordinating services, facilitating referrals, monitoring outcomes, addressing barriers to care, and connecting individuals with appropriate resources. The RN Case Manager serves as an advocate and trusted clinical resource, helping promote continuity, improve health outcomes, and ensure patients receive timely and comprehensive care. This position provides comprehensive care coordination for patients as assigned. This position assesses the patient's plan of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through their care, facilitating options and services to meet the patient's health care needs. The intensity of care coordination provided is situational and appropriate based on patient need and payer requirements. This position is accountable for the quality of clinical services delivered by both them and others and identifies/resolves barriers which may hinder effective patient care.

Requirements

Must possess knowledge of case management or utilization review as normally obtained through the completion of a bachelor's degree in case management or health care.
Requires current Registered Nurse (R.N.) license in state worked.
Basic Life Support (BLS) certification is also required.
Requires a proficiency level typically achieved with 5 years clinical experience.
Must have a working knowledge of care management, acute care and/or home care environments, community resources and resource/utilization management.
Must demonstrate critical thinking skills, problem-solving abilities, effective communication skills, and time management skills.
Must demonstrate ability to work effectively in an interdisciplinary team format.
For assignments in an acute care setting, must be able to work flexible hours and take rotating call after hours.
Foundation Registry and Travel positions require a minimum of one year experience in an acute care hospital and/or home care setting.
Experience must include working in an acute care and/or home care setting within the past 12 months as a Case Manager in the specialty area.

Nice To Haves

CCM (Certified Case Manager) preferred

Responsibilities

Manages individual patients across the health care continuum to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
Acts in a leadership function with process improvement activities for populations of patients to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
Acts in a leadership function to collaboratively develop and manage the interdisciplinary patient discharge plan. Effectively communicates the plan across the continuum of care.
Evaluates the medical necessity and appropriateness of care, optimizing patient outcomes. Assesses patient admissions and continued stay utilizing standard criteria. Identifies issues that may delay patient discharge and facilitates resolution of these issues.
Establishes and promotes a collaborative relationship with physicians, payers, and other members of the health care team. Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements.
Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts into daily practice.
May supervise other staff.
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Foundation Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.