RN Case Manager

Summary\: Coordinates services through an interdisciplinary process which provides a clinical and psychosocial approach through the continuum of care. Assists in development, planning, coordination and administration of the activities of clinical review, discharge planning, resource utilization and utilization review.

1. Assesses the continuity of care, expedites and coordinates the delivery of services to facilitate a patient's progress throughout the continuum of care. Aggressively seeks appropriate placement to other settings/level of care as soon as medically stable for discharge, assuring a safe disposition.

2. Assists in the development of patient care protocols and in updating patient procedures for care of a select group of patients. Maintains current knowledge of the identified case specialty to review an interpretation of the literature and community resources. Ability to gather and interpret data as it pertains to clinical and resource management.

3. Applies accepted admission clinical guidelines to screen admissions to determine necessity of admission. Assist in timely management of all outpatient/observation patients.

4. Provides assessment, planning, implementation, evaluation, and interactions with patients and family members. Communicates findings with all members of the interdisciplinary team.

5. Assumes leadership role to facilitate interdisciplinary collaboration, to include but not limited to outlier rounds, self-pay rounds and observation rounds.

6. Functions without direct supervision, utilizing time constructively and organizing assignments for maximum productivity.

7. Facilitates patient and family education, and the discharge process to promote continuity of care, optimal patient outcomes and readmission prevention.

8. Demonstrates compliance in documentation, related to patients continuum of care, State, Medicare, and JCAHO regulatory requirements. Documentation provides a clear understanding of patient interaction, hospital course, anticipated discharge needs and/or barriers to discharge.

9. Concurrently identifies and manages day and cost outliers, documents validation of continued hospitalization. Works with insurance companies to provide information to justify admission and continued length of stay.

10. Identifies and assigns proper discharge disposition code. Demonstrates proficiency at hospital wide and/or department specific computer software and technology.

Education\: Associate's degree. Master's/Bachelor's Degree preferred.

Experience\: Five (5) years experience preferred. 2 years of clinical/hospital experience or 2 years of experience in like areas required.

Skills\: Able to interview others, strong analytical and organizational skills and team facilitation and meeting skills.

Licenses/Certifications\:Current RN Licensure in Arizona and BLS Certification.