What are the responsibilities and job description for the RN-CASE MGR | CASE MANAGEMENT position at MEDICAL WEST HOSPITAL AUTHORITY?
About the Role:
The RN-Case Manager plays a critical role in coordinating and managing patient care to ensure optimal health outcomes. This position involves assessing patient needs, developing individualized care plans, and facilitating communication among healthcare providers, patients, and families. The RN-Case Manager monitors patient progress, advocates for necessary services, and ensures compliance with healthcare regulations and organizational policies. By effectively managing resources and coordinating care transitions, this role helps reduce hospital readmissions and improves overall patient satisfaction. Ultimately, the RN-Case Manager serves as a vital link between clinical care and administrative processes to promote efficient, high-quality healthcare delivery.
$10,000 Sign-On Bonus
Minimum Qualifications:
- Current and valid Registered Nurse (RN) license in the United States.
- Bachelor of Science in Nursing (BSN) or equivalent nursing degree.
- Minimum of two years clinical nursing experience, preferably in case management or a related healthcare setting.
- Strong knowledge of healthcare systems, insurance processes, and regulatory requirements.
- Excellent communication, organizational, and critical thinking skills.
Preferred Qualifications:
- Certification in Case Management (CCM) or Accredited Case Manager (ACM) credential.
- Experience with electronic health records (EHR) and case management software.
- Familiarity with chronic disease management and utilization review processes.
- Master’s degree in Nursing, Healthcare Administration, or related field.
- Experience working in diverse healthcare environments including acute care, home health, or managed care.
Responsibilities:
- Conduct comprehensive assessments of patients' medical, psychosocial, and environmental needs to develop personalized care plans.
- Coordinate with multidisciplinary healthcare teams to implement and monitor care plans, ensuring continuity and quality of care.
- Facilitate communication between patients, families, healthcare providers, and insurance companies to advocate for patient needs and access to services.
- Monitor patient progress and outcomes, adjusting care plans as necessary to address changing health conditions or barriers to care.
- Document all case management activities accurately and timely in compliance with regulatory standards and organizational policies.
- Provide education and support to patients and families regarding treatment options, disease management, and available community resources.
- Collaborate with discharge planners and community agencies to ensure smooth transitions from hospital to home or other care settings.
Skills:
The RN-Case Manager utilizes clinical expertise and critical thinking skills daily to assess patient needs and develop effective care plans. Strong communication skills are essential for collaborating with multidisciplinary teams and advocating for patients’ access to necessary services. Organizational skills enable the RN-Case Manager to manage multiple cases simultaneously while ensuring accurate documentation and compliance with healthcare regulations. Proficiency with electronic health records and case management software supports efficient tracking of patient progress and coordination of care. Additionally, knowledge of insurance processes and healthcare systems helps the RN-Case Manager navigate barriers to care and optimize resource utilization.