What are the responsibilities and job description for the CASE MANAGER position at Premier Health?
INTEGRATED CARE MGT PROGRAM
FULL TIME/DAYS/80 HOURS PER PAY
The Case Manager is a registered nurse responsible for individualized patient assessment and care coordination, and transition planning to promote maximal outcomes in relation to appropriate length of stay, effective use of resources and established guidelines of care. Additional responsibilities include facilitation of interdisciplinary team collaboration, liaison between the patient, physician, payor, family/significant others in regards to care coordination and transitional care needs. This position requires expertise in acute care nursing, healthcare reimbursement requirements, clinical outcome data analysis, utilization management, transition planning and process, resource allocation, team management and communication skills.
Promotes care coordination and effective utilization of resources through the assessment of patient care needs during the hospitalization and across the health care continuum. Success is measured against achievement of targeted goals and outcomes as generated by defined expectations through care team collaboration.
Education: BSN Required.
Licensure: Registered Nurse with valid Ohio license.
Certification: Certification in area of clinical specialty (Case Management, Neuro, Critical Care, Rehab or related) preferred.
Experience: Minimum of three years of relevant clinical experience in area of patient population within last five
years. Expertise in healthcare reimbursement, discharge planning and case management
preferred. Experience with a clinical documentation management program preferred.
Skills/Other: Exemplary interpersonal skills as demonstrated by the ability to develop and maintain rapport with
physicians and Integrative Care Team members. Negotiation skills, conflict resolution skills and
assertive communication skills required. Knowledge of InterQual ISD-A and Milliman Guidelines
and third party insurance requirements preferred. Computer skills expected