Case Manager RN - Full Time, Days & Afternoon Shifts with weekends
Responsible to Trumbull Regional Medical Center for supporting the corporate mission, vision and values. Responsible to Case Management at TRMC to utilize an interdisciplinary approach to managing patient throughput in a fiscally responsible manner to achieve optimal outcomes. The Case Manager applies knowledge of the expected clinical trajectory, available resources, and relevant standards of care in anticipating patient needs and coordinating the plan of care. Efficient utilization of health care resources and timely transition to the next appropriate level of care are a priority. Responsible to the customer for courteous, accurate, timely service.
RESPONSIBILITIES AND MAJOR DUTIES
- Coordinates clinical care services to ensure consistent standards of care and appropriate use of resources; and to prevent unnecessary delays
- Facilitates psychosocial care coordination to ensure timely identification and resolution of psychosocial issues impacting patient throughput
- Effectively manages resource utilization to ensure efficiency and appropriate reimbursement.
- Proactively initiates discharge planning to facilitate timely patient transition to the next level of care
- Collaborates with medical staff members to promote complete and accurate physician documentation in the medical record
- Integrates clinical, financial, ethical, compliance, and other variables in complex decision making.
- Actively participates in projects designed to reduce costs, capture lost revenue, or enhance efficiency.
- Educates medical staff and others regarding documentation, medical necessity, available resources, and reimbursement issues.
- Develops and maintains a working knowledge of current reimbursement methods and regulations pertinent to case management practice.
- Performs other related duties as assigned.
The above statements reflects the general duties considered necessary to describe the principal functions of the job as identified, and shall not be considered as a detailed description of all the work assignments that may be inherent in the job.
EDUCATION AND EXPERIENCE
Associate degree or diploma in nursing from a college or technical school required. Bachelor’s degree in nursing strongly preferred. Requires up to five year’s experience on this or related jobs in a hospital or healthcare facility to develop the judgement necessary to make appropriate decisions and to handle emergency situations.
LICENSURE, REGISTRATION AND/OR CERTIFICATION