RN - Care Manager | 0.1 IPT

Phelps Health

1d•Onsite

About The Position

The Care Manager is accountable and responsible for coordinating the care and services of the assigned patient populations. The care manager promotes effective utilization and monitoring of health care resources and ensures appropriate placement across the continuum. The care manager assumes a leadership role with the Multidisciplinary Care Team (MDC) to achieve optimal clinical, financial and resource outcomes.

Requirements

Graduate of an accredited School of Nursing or Social Work required, OR Equivalent years of experience in Case Management with at least a Bachelor’s degree in any field required.
At least 2 years of applicable clinical experience.
Missouri or Compact RN license, if applicable.
BLS through American Heart Association required.

Nice To Haves

Bachelor’s in Nursing or Master’s in Social Work preferred.
Experience with utilization management, discharge planning, and third party payors preferred.
Case Management certification preferred.

Responsibilities

Promotes effective utilization and monitoring of health care resources.
Ensures appropriate placement across the continuum through medical necessity for admission, continued stay, or alternative treatment facilities, agencies, and/or resources.
Assumes a leadership role with the Multidisciplinary Care Team (MDC) and collaborates with other healthcare team members to achieve optimal clinical, financial and resource outcomes.
Contributes to the development of a goal directed plan of care that is prioritized and based on determined medical diagnosis, patient problems, co-morbidities, and expected patient outcomes.
Evaluates effectiveness of care.
Completes, coordinates, and communicates the discharge plan in a timely manner with the patients, significant others, and providers of care based on age, social determinants of health needs, and patient's choice.
Follows regulatory guidelines to inform patients of their rights related to observation care, patient choice, and appeals in discharge.
Communicates directly with patients, significant others, and providers of care during the denial process to include issuing denial letters and assisting in appealing hospital denials prior to and after the discharge of a patient.