RN-CASE MANAGER
Department Name PSYCHIATRY Job Description POSITION SUMMARYTo coordinate, negotiate and obtain services and resources for the care of patients.
To review case criteria to determine medical necessity for admission and continued stay.
To provide discharge planning and care coordination that identifies the most cost-effective methods of patient care.
Exempt (Salaried - Not eligible for overtime)MINIMUM REQUIREMENTSGraduate from an accredited School of Nursing and three (3) years of related experience.
Work experience may NOT substitute for minimum education requirement.
CORE JOB RESPONSIBILITIES AND SKILLSCoordinates patient placement in post acute care provider facilities.
Performs cost/benefit analysis to determine the most cost effective post acute care plan for patients.
Refers all potential quality care issues to the performance improvement director daily to facilitate timely follow-up.
Documents all discharge planning referrals and all discussions with the patient, family and care team members.
Educates physicians and other care team members on level of care criteria and other third party payer requirements.
Explores and implements strategies to reduce the length of stay within assigned caseload.
Identifies the need for new resources if gaps exist in service continuum and initiates creative care delivery options.
Monitors the effectiveness of the patient's care plan in reaching identified goals.
Intervenes when necessary to address potential progression delays.
Applies general medical necessity criteria to patient medical records and abstracts relevant patient care data to determine the appropriate level of patient care.
Other Requirements CONTACTSAdult:
28 years and 1 day - 60 years Adolescent:
12 years and 1 day - 18 years Geriatric:
60 years and 1 day or older Toddler:
1 year and 1 day - 3 years Neonate:
Birth - 1 year Preschool:
3 years and 1 day - 5 years School:
5 years and 1 day - 12 years Young Adult:
18 years and 1 day - 28 yearsPHYSICAL REQUIREMENTS / ENVIRONMENTTwist Occasionally, up to 20% of the time Carry/Lift Body Fluid Exposure:
YesSUPERVISORY / BUDGET RESPONSIBILITIESNo fiscal responsibility.
No supervisory responsibility.
Preferred Qualifications LICENSES / CERTIFICATIONS / REGISTRATIONSCurrently licensed as a Registered Nurse in the State of Alabama or eligible to be licensedKNOWLEDGE / SKILLS / ABILITIESAbility to operate various office machines including printers, computers and various software packages Interpersonal skills Analytical skills Organizational skills Process improvement and quality skills Written and verbal communication skills Ability to problem-solve Ability to multi-task Project management skills Knowledge and clinical competence in nursing care, knowledge and skills Negotiation skills Conflict resolution skills Knowledge and experience in healthcarePosition Status Regular Shift Days Full-Time/Part-Time Full-Time Hours Per Week 40 Location Shelby Baptist Medical Center Address Line 1 Box 488 City Alabaster Zip Code 35007 Auto req ID 1993BR Removal Date 24-Apr-2015.
Estimated Salary: $20 to $28 per hour based on qualifications.
To review case criteria to determine medical necessity for admission and continued stay.
To provide discharge planning and care coordination that identifies the most cost-effective methods of patient care.
Exempt (Salaried - Not eligible for overtime)MINIMUM REQUIREMENTSGraduate from an accredited School of Nursing and three (3) years of related experience.
Work experience may NOT substitute for minimum education requirement.
CORE JOB RESPONSIBILITIES AND SKILLSCoordinates patient placement in post acute care provider facilities.
Performs cost/benefit analysis to determine the most cost effective post acute care plan for patients.
Refers all potential quality care issues to the performance improvement director daily to facilitate timely follow-up.
Documents all discharge planning referrals and all discussions with the patient, family and care team members.
Educates physicians and other care team members on level of care criteria and other third party payer requirements.
Explores and implements strategies to reduce the length of stay within assigned caseload.
Identifies the need for new resources if gaps exist in service continuum and initiates creative care delivery options.
Monitors the effectiveness of the patient's care plan in reaching identified goals.
Intervenes when necessary to address potential progression delays.
Applies general medical necessity criteria to patient medical records and abstracts relevant patient care data to determine the appropriate level of patient care.
Other Requirements CONTACTSAdult:
28 years and 1 day - 60 years Adolescent:
12 years and 1 day - 18 years Geriatric:
60 years and 1 day or older Toddler:
1 year and 1 day - 3 years Neonate:
Birth - 1 year Preschool:
3 years and 1 day - 5 years School:
5 years and 1 day - 12 years Young Adult:
18 years and 1 day - 28 yearsPHYSICAL REQUIREMENTS / ENVIRONMENTTwist Occasionally, up to 20% of the time Carry/Lift Body Fluid Exposure:
YesSUPERVISORY / BUDGET RESPONSIBILITIESNo fiscal responsibility.
No supervisory responsibility.
Preferred Qualifications LICENSES / CERTIFICATIONS / REGISTRATIONSCurrently licensed as a Registered Nurse in the State of Alabama or eligible to be licensedKNOWLEDGE / SKILLS / ABILITIESAbility to operate various office machines including printers, computers and various software packages Interpersonal skills Analytical skills Organizational skills Process improvement and quality skills Written and verbal communication skills Ability to problem-solve Ability to multi-task Project management skills Knowledge and clinical competence in nursing care, knowledge and skills Negotiation skills Conflict resolution skills Knowledge and experience in healthcarePosition Status Regular Shift Days Full-Time/Part-Time Full-Time Hours Per Week 40 Location Shelby Baptist Medical Center Address Line 1 Box 488 City Alabaster Zip Code 35007 Auto req ID 1993BR Removal Date 24-Apr-2015.
Estimated Salary: $20 to $28 per hour based on qualifications.
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