RN Case Manager Occ Health

Banner Health • Phoenix, AZ

7d • Onsite

About The Position

Banner Occupational Health is seeking a dedicated and experienced Registered Nurse (RN) Case Manager to provide comprehensive care coordination and clinical case management services for assigned patients. This role is responsible for assessing patient needs, developing and implementing individualized plans of care, coordinating resources and services, monitoring patient progress, and facilitating continuity of care throughout the healthcare continuum.

The RN Case Manager works with providers, patients, employers, insurance carriers, and interdisciplinary healthcare teams to promote safe, effective, and cost-efficient care. The intensity and scope of care coordination activities are based on individual patient needs, clinical complexity, and payer requirements. This position is accountable for ensuring the quality of nursing care delivered, identifying barriers to care, and implementing solutions that support optimal patient outcomes.

Banner Occupational Health Clinics are medical clinics specializing in worker's compensation injury care, drug testing, alcohol testing, physical examinations, Department of Transportation exams and Occupational Safety and Health Administration (OSHA) mandated exams. Employers and employees alike benefit from reduced absenteeism and turnover, increased productivity, morale and job satisfaction and are less likely to become sick or injured.

POSITION SUMMARY
This position provides comprehensive care coordination for patients as assigned. This position assesses the patients 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 patients 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.
• For assignments in an acute care setting, Basic Life Support (BLS) certification is also required.
• Requires a proficiency level typically achieved with 3-5 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.
• Banner 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

• Certification for CCM (Certified Case Manager) preferred.
• Additional related education and/or experience preferred.

Responsibilities

• Assess patient healthcare needs and evaluate plans of care to identify opportunities for intervention and support.
• Develop, implement, monitor, and update individualized care coordination plans based on patient needs and clinical goals.
• Coordinate care across the continuum by facilitating communication among patients, providers, employers, payers, and ancillary services.
• Monitor patient progress and evaluate the effectiveness of care plans and interventions.
• Identify actual and potential barriers to care and develop strategies to improve patient outcomes and access to services.
• Facilitate referrals to appropriate healthcare services, specialists, community resources, and support programs.
• Educate patients and families regarding treatment plans, available resources, health management strategies, and care transitions.
• 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.
• Has freedom to determine how to best accomplish functions within established procedures. Confers with supervisor on any unusual situations. Positions are entity based with no budgetary responsibility. Internal customers: All levels of nursing management and staff, medical staff, and all other members of the interdisciplinary health care team. External Customers: Physicians and their office staff, payers, community agencies, provider networks, and regulatory agencies.

Benefits

• Great careers start with great training.
• The people of Banner Health are focused on delivering excellent care to our patients. In return, we are committed to excellence in personal development for all our team members.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level