RN Case Manager - Case Management (Casual)
About The Position
The case manager is responsible for the comprehensive coordination of patient care and services across the continuum of care to promote high-quality, cost-effective, patient-centered outcomes. Working with patients ranging from newborn through geriatric populations, this role integrates clinical case management, utilization management, discharge planning, psychosocial assessment, counseling, and advocacy services. The Case Manager collaborates with patients, families, physicians, interdisciplinary team members, payers, and community agencies to address medical, psychosocial, and resource needs; facilitate appropriate utilization of healthcare services; support informed healthcare decision-making; and ensure safe, timely transitions of care.
Requirements
- Graduate of an accredited school of nursing and licensed in the state of Ohio
- 2 years of clinical experience in an acute care setting
- Knowledge of evidenced-based practice and disease management protocols
- Excellent verbal and written communication skills
- Excellent computer skills
- LMH is accredited by DNV and TJC, and as such, may require specific annual education related to specialty certifications and standards.
Nice To Haves
- Critical care/emergency department experience highly desired
- Utilization review and or discharge planning experience preferred
Responsibilities
- Determines appropriate level of care on admission using hospital approved medical necessity criteria
- Performs patient and care giver assessments to identify pertinent problems/needs
- Organizes assessment data into an individual plan of care, with anticipated outcomes
- Determines continued stay status
- Participates in multidisciplinary rounds
- Participates in patient education
- Tracks and manages potential avoidable hospital days
- Provides clinical information to external providers and managed care organization
- Assists in discharge planning
- Assists in appeals and denials management
- Conduct comprehensive clinical and psychosocial assessments of patients and caregivers to identify medical, emotional, social, financial, and discharge planning needs.
- identify barriers to care, facilitate problem-solving, and connect patients and families with appropriate community resources.
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What This Job Offers
Career Level
Mid Level
