Case Manager /RN

The Case Manager acts as a resource to providers regarding discharge planning, medical record documentation, and all issues that may affect resource utilization and reimbursement. Responsibilities include:

• Concurrent review to include assessment of patient’s clinical, psychological, and financial needs to negotiate efficient movement of the patient throughout the continuum of care.
• Social Services clinical consults (WHC/Family Med) when needed in absence of Social Worker Case Manager or refer to covering Social Worker.
• Discharge planning for all patients.
• Swing Bed Rules and regulations as well as operations.
• Constant monitoring of utilization of hospital services.
• Utilization review phone calls.
• Responsible for department functions in the absence of the Case Management Director.
• Perform utilization management, discharge planning and resource management in accordance with state and federal guidelines and hospital policies and procedures.
• Act as a case management consultant to all disciplines.

Perform other duties as requested or assigned.

QUALIFICATIONS

EDUCATION:

• Participates in mandatory in-services and continuing education programs as mandated by policies and procedures, accreditation, or licensing agencies and as directed by the Department Director.

LICENSE / CERTIFICATION / REGISTRATION:

• Current Kansas RN license or ability to obtain licensure, per Kansas State Board of Nursing regulations.
• CARE Assessment Certification through KDADS.
• Certification in Case Management preferred but not required.
• BLS - Obtains RQI BLS certification within appropriate quarter (approximately within 3 months of hire), maintains quarterly RQI requirements.

EXPERIENCE:

• One year experience as a RN staff in a hospital setting preferred.
• Knowledge of community services preferred.
• Knowledge of MCG criteria preferred.
• Computer experience required.