RN Case Manager - Case Management PRN (Clarendon) (20182502)

Job Summary: Responsible for the coordination and implementation of case management strategies pursuant to the Case Management Plan. Works with all members of the healthcare team to assure a collaborative approach is maintained in care and treatment of the patient from admission through discharge. Reviews care and treatment for appropriateness against screening criteria to include infection control, quality and risk assessment. Responsible for authorization of appropriate services for continued stay through discharge. Assist Social Services Coordinator with discharge service needs as required. Assist Quality Department Staff and Risk Manager with screening, investigation and problem solving as needed. Assists the Utilization Management Department with all utilization activities as requested and directed. Participates in education on and the implementation of clinical guidelines and protocols. Initiates and continues contact with patients and /or caregiver as appropriate to age, condition, and situation to provide Level of Care, Insurance information, CMS notification as required by Medicare/ Medicaid et al. Participates in performance improvement activities, frequently attending and participating in performance improvement team efforts. Performs Quality Improvement reporting via computerized database. Maintains updated knowledge base for Quality Improvement criteria. Seeks or is certified in Case Management and maintains CEU requirements for this certification on annual basis.
Schedule: PRN.
Regulatory Requirements:
Current State Registered Nurse Licensure.
3 or more years case management experience preferred.
5 or more years acute care hospital experience required.

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