Registered Nurse Case Manager
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POST DATE 9/13/2016
END DATE 10/19/2016
San Antonio, TX
JOB DESCRIPTIONJob Code: 01574-69003
The RN Case Manager will work with patient/families identified to have discharge planning, psychosocial, financial, or other needs to develop a plan. The developed plan will: 1) Optimize functional and self-care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of efforts among health care team members; and 4) promote quality, cost effective outcomes. The Case Manager will demonstrate knowledge and skills necessary to develop a plan based on physical, psychosocial, educational, and age related criteria.
Essential Job Functions:
1. Assesses discharge needs of all high-risk patients (and others referred). Identifies resources available to address the needs identified, coordinate referrals, and document plan.
2. Utilize community resources to support patient s post hospital needs. Documents choice in available resources.
3. Performs admission and continued stay reviews. Provides clinical information to payers upon request for certification and reimbursement of care. The RN Case Manager discusses alternate levels of care with physician. Refers cases not meeting acute care criteria to Physician Advisor as needed.
4. Facilitates and provides education of hospital staff, physicians, patients, and caregivers for purposes of efficient resource utilization
5. The RN Case Manager is knowledgeable of all JCAHO, HCFA, and state/federal requirements for provision of care, planning, and documenting.
6. Tracks resource statistics to identify improvement opportunities. Reports findings at medical staff and other hospital committee meetings.
EDUCATION REQUIRED AND/OR PREFERRED:
* 1. Graduate of an accredited diploma, associates, or baccalaureate degree nursing program. (required)
* 1. Current Texas licensure as a Registered Nurse (required)
* 2. Bachelor of Science in Nursing (preferred)
* 1. Minimum of 3 years clinical experience in area in which Case Management was performed. (preferred)
* 2. At least one year experience in utilization review, resource management, discharge planning, or case management. (preferred)
Last Edited: 05/12/2016