Case Manager

About This Role

The Case Manager is a Registered Nurse responsible for individualized patient assessment, care coordination, and transition planning to promote maximal outcomes and effective use of resources.

Responsibilities

• Provide individualized patient assessment
• Coordinate patient care and transition planning to promote maximal outcomes
• Ensure appropriate length of stay and effective use of resources
• Facilitate interdisciplinary team collaboration
• Act as a liaison between the patient, physician, payor, and family/significant others regarding care coordination and transitional care needs
• Promote care coordination and effective utilization of resources through assessment of patient care needs

Requirements

• BSN
• Registered Nurse with valid Ohio license
• Minimum of three years of relevant clinical experience in area of patient population within last five years
• Exemplary interpersonal skills
• Negotiation skills
• Conflict resolution skills
• Assertive communication skills
• Experience in gathering information, monitoring indicators and feedback mechanisms
• Basic computer skills

Qualifications

• BSN required
• Minimum of three years of relevant clinical experience in area of patient population within last five years

Nice to Have

• Certification in area of clinical specialty
• Expertise in healthcare reimbursement, transition planning and case management
• Experience with a clinical documentation management program
• Knowledge of performance improvement process
• Knowledge of InterQual ISD-A and Milliman Guidelines
• Knowledge of third party insurance requirements