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Case Manager Registered Nurse
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Greenville, SC Greenville, South Carolina |
About this job
ST. FRANCIS HOSPITAL
POSITION SUMMARY
The RN Case Manager is a key contributor to the overall financial, quality, and clinical performance at St. Francis Health System. The RN Case Manager will facilitate the extraction of all clinical documentation necessary to qualify a patient for hospital level of care utilizing the information maintained in the electronic medical record (ConnectCare). Provide a positive financial impact to the institution through interaction with physicians, nursing staff, other patient care givers, and coding professionals to ensure that medical record documentation accurately reflects the level of services rendered to patients and the clinical information utilized in profiling and reporting outcomes is complete. Monitor and evaluate care to ensure costs are medically necessary, provided in the most appropriate setting, and are generated according to governmental and regulatory agency standards. Identification and reporting of potential quality of care issues and reporting of variances through the Quality Improvement Program. Educate all members of the patient care team on documentation guidelines on an ongoing basis. Responsible for the timely coordination of health care services for selected patient populations to meet specific health care needs in a cost-effective manner. Support an outcomes-oriented patient care delivery system, which places the patient at the center of all activities. Coordinate patient education to promote independence and the ability to care for one's self. Serve as the primary clinical resource to assist the social worker in developing, altering and expanding the discharge plan of care on high-risk patients to encompass multidisciplinary patient care needs.
JOB REQUIREMENTS
1. Graduate of an NLN accredited school of nursing.
2. Bachelor of Science degree in Nursing (BSN) or currently enrolled in a BSN program.
3. Current, unrestricted license to practice nursing in the State of South Carolina.
4. Five (5) years of recent acute care nursing or four (4) years recent clinical experience, and one year utilization review
experience.
5. High level of clinical skills required.
6. Utilization management experience preferred.
7. Familiar with Medicare MS-DRGs and Medicare PPS preferred.
8. Performance Improvement (PI) experience preferred.
9. Clinical leadership experience preferred.
10. InterQual ISD Acute Care Adult (IQ) or related medical review criteria experience preferred.
11. Knowledge of acute care regulatory/accreditation requirements preferred.
12. Excellent computers skills and current knowledge of the electronic medical record.
13. Certified Case Manager (CCM) certification preferred.
POSITION SUMMARY
The RN Case Manager is a key contributor to the overall financial, quality, and clinical performance at St. Francis Health System. The RN Case Manager will facilitate the extraction of all clinical documentation necessary to qualify a patient for hospital level of care utilizing the information maintained in the electronic medical record (ConnectCare). Provide a positive financial impact to the institution through interaction with physicians, nursing staff, other patient care givers, and coding professionals to ensure that medical record documentation accurately reflects the level of services rendered to patients and the clinical information utilized in profiling and reporting outcomes is complete. Monitor and evaluate care to ensure costs are medically necessary, provided in the most appropriate setting, and are generated according to governmental and regulatory agency standards. Identification and reporting of potential quality of care issues and reporting of variances through the Quality Improvement Program. Educate all members of the patient care team on documentation guidelines on an ongoing basis. Responsible for the timely coordination of health care services for selected patient populations to meet specific health care needs in a cost-effective manner. Support an outcomes-oriented patient care delivery system, which places the patient at the center of all activities. Coordinate patient education to promote independence and the ability to care for one's self. Serve as the primary clinical resource to assist the social worker in developing, altering and expanding the discharge plan of care on high-risk patients to encompass multidisciplinary patient care needs.
JOB REQUIREMENTS
1. Graduate of an NLN accredited school of nursing.
2. Bachelor of Science degree in Nursing (BSN) or currently enrolled in a BSN program.
3. Current, unrestricted license to practice nursing in the State of South Carolina.
4. Five (5) years of recent acute care nursing or four (4) years recent clinical experience, and one year utilization review
experience.
5. High level of clinical skills required.
6. Utilization management experience preferred.
7. Familiar with Medicare MS-DRGs and Medicare PPS preferred.
8. Performance Improvement (PI) experience preferred.
9. Clinical leadership experience preferred.
10. InterQual ISD Acute Care Adult (IQ) or related medical review criteria experience preferred.
11. Knowledge of acute care regulatory/accreditation requirements preferred.
12. Excellent computers skills and current knowledge of the electronic medical record.
13. Certified Case Manager (CCM) certification preferred.