CASE MANAGER at Premier Health

Dayton, Ohio, United States -

Full Time

Start Date

Immediate

Expiry Date

14 May, 26

Salary

0.0

Posted On

13 Feb, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Registered Nurse, Patient Assessment, Care Coordination, Transition Planning, Utilization Management, Interdisciplinary Team Collaboration, Healthcare Reimbursement, Clinical Outcome Data Analysis, Resource Allocation, Team Management, Communication Skills, Negotiation Skills, Conflict Resolution, Assertive Communication, InterQual ISD-A, Milliman Guidelines

Industry

Hospitals and Health Care

Description

General Summery Position: Case Manager (RN) Dept: Integrated Care Management Program Shift: Part Time -0830-1700 / 48 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 preferred. Experience: Minimum of three years of relevant clinical experience in area of patient population within last five years. Expertise in healthcare reimbursement, transition planning and case management preferred. Experience with a clinical documentation management program preferred, knowledge of performance improvement process preferred. Skills/Other: Exemplary interpersonal skills as demonstrated by the ability to develop and maintain rapport with physicians and Integrated 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. Experience in gathering information, monitoring indicators and feedback mechanisms required. Basic computer skills required.

Responsibilities

The Case Manager, an RN, is responsible for individualized patient assessment, care coordination, and transition planning to optimize outcomes, length of stay, and resource utilization according to established guidelines. This role involves facilitating interdisciplinary team collaboration and acting as a liaison between the patient, physician, payor, and family regarding care coordination and transitional needs.