Case Manager-RN
Columbus, GA
$62,000 - $94,000
Job Description
Under the general supervision of the Case Management Director, acts as a patient advocate/ Case Manager to hospital clients. An autonomous role that coordinates, negotiates, procures services and resources for, and manages the care of complex patients to facilitate achievement of quality and cost-effective patient outcomes.
Essential Functions include but are not limited to:
· Knowledge of and works within the CMS Conditions of Participation for Discharge planning
· Timely assessment of patients identified with discharge planning needs
· Development and implementation of discharge plans for each patient targeting optimal cost and quality outcomes
· Re-evaluation for discharge needs upon change of condition of the patient or caregiver's ability to care for the patient
· Maximizes care coordination efforts and collaborates with the healthcare team to promote efficient movement through the continuum of care
· Identifies and mitigates delays in the delivery of care
· Effective and appropriate communication with the healthcare team, patient, and family
· Timely, appropriate, and accurate documentation of the discharge plan, patient progress to plan, and communication with the healthcare team, patient, and family in the medical record
· Assists the Director of Case Management with collection of data for the UM Committee and other reports
· Escalates cases appropriately
· As required, collaborates with payers to ensure authorization for discharge plan needs
· Participates in Interdisciplinary Rounds
· Displays effective communication skills
· Assists the Director of Case Management with other job duties as requested
· Demonstrates knowledge of HIPAA guidelines and utilizes them in all aspects of communication
Education:
· Associate degree in Nursing required. Bachelor's Degree in Nursing is desirable. The Registered Nurse must possess a license to practice in the state of Georgia.
Experience:
· 5 or more years in the acute care setting. Experience in other related healthcare settings considered. Previous case management experience is desirable, but not required.