RN Case Manager
RN Case Manager
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Salary Not Disclosed
1 Vacancy
Job Description
At Central Maine Healthcare our team members are committed to providing exceptional care and experiences for our community and for each other every day.
Position Summary:
The Care Manager assesses plans implements and evaluates the needs of patients for discharge planning and utilization review. This includes those who may have Medicare Medicaid HMO or private insurance to cover their stay at various units. Discharge planning is coordinated with physicians nursing patients and significant others who have an ongoing caring relationship with the patient. Utilization review procedures include those stated for discharge planning in addition to knowledge of criteria for Medicare Medicaid coverage and that of HMO or private insurers.
Education and Experience:
- Graduate of an accredited school of nursing with at least 1 year of RN experience
- Current RN license within the state of practice.
- Current American Heart Association Healthcare Provider BLS required. BSN or equivalent experience required.
Essential Duties:
- Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors.
- Communicates with the physician regarding the discharge-planning needs of the patient. Assists the physician to facilitate post-hospital care.
- Responsible for performing assessments on Medicare Medicaid and high-risk patients to determine discharge planning needs; always documents assessments.
- Communicates daily with admissions personnel regarding admissions and discharges to various units/facilities. Consults other departments as appropriate to collaborate on patient care and performance improvement activities.
- Initiates ongoing communication with the patient and the patients family to assess discharge needs. Communicates with family members and caretakers regarding the needs of the patient and anticipated plans. Determines the type of assistance/setting/resources necessary for the patient/family and provides appropriate resources/assistance list of facilities.
- Interacts professionally with patient/family and involves patient/family in the formation of the plan of care
- Documents discharge planning in an ongoing manner. Documentation meets current standards and policies.
- Cooperates with Case Managers activities with the insurance company based on information received.
- Takes appropriate action to recover from a service difficulty ensuring that the necessary action is taken to affect a resolution to the customers problem.
- Maintains and respects the confidentiality of patient/physician/personnel information
- Participates in Utilization Management Committee CQI varying team meetings and other meetings as appropriate.
- Mentors educates guides and monitors nursing staff in the delivery of nursing care/practice.
- Demonstrates knowledge of patients financial status diagnosis and discharge needs.
- Responsible for home care needs to be met by the time of discharge with a goal of arrangements completed 24 hours before discharge when the rate of discharge is known.
If you are passionate about making a difference and are looking for your next great career opportunity we look forward to reviewing your application!
Required Experience:
Manager
Employment Type
Full-Time
