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Responsibilities:
The Case Manager coordinates, manages and procures the discharge needs of patients identified as requiring post-acute care services via initial admission screen, assessment and consults. This is achieved by collaboration with the family, the care team including physicians, nursing and other healthcare professionals. The Case Manager performs daily utilization review and conveys pertinent telephonic information to third party payers to secure appropriate acute care reimbursement within the time requirements of the payer. The Case Manager appeals 100% of all third party payer denials for acute care reimbursement according to the guidelines for the PA Region. The Case Manager performs ongoing PI/QA during concurrent review to identify quality of care issues, risk management issues, and performs blood/blood products and medication utilization.
Qualifications:
Education Requirements
· 4 year/bachelor's degree
Experience
· Relevant Experience
Certification and Licensure
· PA Registered Nurse License
Required Skills
· Computer Skills to include use and navigation.
· Excellent Communications Skills
· Excellent Interpersonal Skills
· Microsoft Word
Summary
The RN Case Manager position requires a skilled professional with a strong background in managed care, patient service, and nursing. The ideal candidate should possess in-depth knowledge of patient care, physiology, and medical terminology. Experience in hospital settings and proficiency in patient assessment and discharge planning are essential for success in this role. Premium skills such as critical care, ICU, and behavioral health experience would be advantageous. The candidate must hold a Bachelor's degree, an RN license, and demonstrate proficiency in Microsoft Word and computer skills. The RN Case Manager will play a crucial role in coordinating patient care, ensuring compliance with HIPAA regulations, and facilitating effective communication between healthcare providers and patients.
Job Type: Full-time
Pay: $80,000.00 - $100,000.00 per year
Benefits:
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Work Location: In person
Full Time
$91k-109k (estimate)
05/19/2024
09/15/2024
The job skills required for RN Case Manager include Case Management, Patient Care, Acute Care, Collaboration, Discharge Planning, Managed Care, etc. Having related job skills and expertise will give you an advantage when applying to be a RN Case Manager. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by RN Case Manager. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for RN Case Manager positions, which can be used as a reference in future career path planning. As a RN Case Manager, it can be promoted into senior positions as a Case Management Director that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary RN Case Manager. You can explore the career advancement for a RN Case Manager below and select your interested title to get hiring information.
If you are interested in becoming a RN Case Manager, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a RN Case Manager for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on RN Case Manager job description and responsibilities
Case Managers act as patient advocates and make sure the needs of the patient are met effectively and efficiently.
12/13/2021: Burlington, VT
Case Managers generally work with patients that have chronic health conditions such as diabetes, heart disease, seizure disorders, and COPD.
02/20/2022: Altus, OK
The Case Manager RN reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation s
01/12/2022: Rochester, NY
Prepares all required documentation of case work activities as appropriate.
01/28/2022: Lexington, KY
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on RN Case Manager jobs
Before becoming an RN case manager, a nurse would be expected to earn some clinical experience.
01/18/2022: Concord, NH
Graduate from an Accredited Nursing Program.
01/10/2022: Albany, NY
Gain Experience Working as a Nurse.
01/10/2022: Worcester, MA
They should be familiar with emerging professional and technical aspects and have RN case management experience.
01/27/2022: Santa Rosa, CA
Step 3: View the best colleges and universities for RN Case Manager.