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RN Case Manager

Category:

Nursing

Department:

Nursing Admin

Description:

The Case Manager provides ongoing support and expertise through comprehensive assessment, planning,
implementation and overall evaluation of individual patient needs. The overall goal of the position is to
enhance the quality of patient management and satisfaction, to promote continuity of care and cost
effectiveness through the integration of case management, utilization review, discharge planning and
swingbed program management. This position has accountability for the care, coordination and
discharge planning of Med-Surg patients.


KEY RESPONSIBILITIES:
-Med-Surg case management, utilization review and discharge planning.
-Swingbed program management including marketing and community outreach.
-Coordinate the integration of post-discharge needs into patient care plans.
-Coordinate hospital activities related to case management, utilization review and discharge planning
through various Committee participation.
-Conduct concurrent and retrospective chart reviews using specified indicators and criteria.
-Serves as a patient advocate.
-Investigates and reports quality concerns and adverse events.
-Performs staff education related to resource utilization, discharge planning and the psychosocial aspects
of healthcare delivery.
-Coordinates daily bed huddles Monday-Friday for multi-disciplinary care coordination.
-Promotes effective and efficient use of clinical resources.
-Manages authorization, denials and other payer issues as appropriate.
-Works with other departments, physicians and staff to ensure adherence to established criteria for
admission and discharge.
-Maintains an effective working relationship with admitting providers to ensure optimal patient outcomes
and coordination of care.
-Completes the appropriate patient assessments, including assessment of psychosocial and cultural needs.
-Assesses patient’s progress through expected hospital course.
-Maintain knowledge of community based and county resources to promote care continuity and patient
safety post discharge.
-Work with the appropriate agencies and makes necessary referrals to intervene for patient safety
concerns.
-Serves as a liaison between the patient, family and healthcare providers.
-Participates in and supports the development and actualization of the Department of Nursing’s goals.
-Assists in communicating the philosophy and expectations of the Department of Nursing.
-Intervenes and takes appropriate action in situations related to violation of hospital policy or employee
injury.
-Reviews admission reports for appropriate observation versus inpatient classifications and takes action
when necessary.
-Conducts quality improvement activities via chart audits and other processes.
-Complete other duties as assigned.

QUALIFICATIONS & EDUCATION:
-Current Texas Registered Nurse licensure. Bachelor of Science in Nursing preferred. Case Management
certification preferred. BLS required within 30 days of hire.
-RN License to practice as a professional Registered Nurse in the State of Texas or Active Multi-State RN, Compact License, or GN Permit. (Employees with RN Compact Licensure are required to obtain Texas RN License within 90 days of hire date.)
-Two years RN clinical experience preferred. Previous case management or utilization review experience
preferred.

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, national origin, sexual orientation, gender identity, marital status, disability, protected veteran status, or any other characteristic protected by law. Medina Healthcare System is a drug-free and tobacco-free employer with smoke free campuses. This job description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

Closing:

Open until filled

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