The individual in this position is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual in this position has overall responsibility to ensure that care is provided at the appropriate level of care based on medical necessity and assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions.
Balances clinical and financial requirements and resources in advocating for patient needs with judicious resource management Promotes prudent utilization of all resources (fiscal, human, environmental, equipment and services) by evaluating resources available to the patient and balancing cost and quality to assure optimal clinical and financial outcomesIntegrates key elements of patient assessment, patient choice and available resources to develop and implement a successful transition plan Identifies patients at risk for readmission and applies appropriate intervention including risk assessment and referral to Social Work (SW) and/or Complex Case ReviewScreens patients for factors that may affect the progression of care and intervenes as needed to promote timely and appropriate throughputPerforms related duties as requiredRequired:
Graduate of an accredited school of nursingExperience: 2 years of acute hospital case management or healthcare experience. Licensure/Certification: Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy. Active RN license for state(s) covered.
Preferred:
Academic degree in nursing (bachelor's or master's)
5 years of acute hospital case management leadership experienceLicensure/Certification: Accredited Case Manager (ACM)