RN Case Manager
RN Case Manager
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Salary Not Disclosed
1 Vacancy
Job Description
Qualifications for RN Case Manager:
- The Case Manager is responsible for managing a continuum of care from admission through discharge for assigned patients.
- Partners with medical staff utilizes scientific evidence for best practices relevant data and compliance with the mission/philosophy standards goals and core values.
- Participates in the development of patient focused long/short term goals implementing evaluating and modifying the care plan.
- Collects and reports utilization data and quality information such as delays in service possible avoidable days provider preventable conditions readmissions and length of stays etc.
- Assists in preparing UM/QI case issues gathering requested records/responses.
- Consults with the nursing staff working directly with clients in the nursing care areas.
- Maintains current knowledge of evidence based nursing care practices.
- Educates nursing staff about state and federal rules and regulations in preparation for accreditation.
- Evaluates and verifies employee performance through the review of completed work assignments and work techniques.
- Ensures delivery of quality care to patients enhancement of business development and continuous improvement of agency efficiency and fiscal success.
- Provides instruction to hospitalized members and their families; and serves as liaison between the member the physician the hospital and the Plan.
- Case Manager completes appropriate accurate and timely documentation into EMR system every shift
Requirements for Case Manager:
- Active CA Registered Nurse
- Acute clinical experience
- Experienced in case management UR/UM
- Possesses knowledge of applicable regulatory standards and is able to perform audits based upon these standards
- Solid experience dealing with UR concepts
- Computer literate
Required Experience:
Manager
Employment Type
Contract
