What are the responsibilities and job description for the RN Case Manager position at Mason General Hospital?
Case Manager: This 1.0FTE/Full-time position is scheduled to work 10-HR day shifts on variable days of the week.
Compensation: Non-exempt, $51.05/HR-$72.89/HR
Benefits:
At Mason Health, we are committed to providing our employees with a comprehensive benefits package that supports both your professional growth and personal well-being. Whether you are a Part-time or Full-time member:
Health & Wellness Benefits:
- Medical, Dental & Vision Insurance – With employer paid premiums for full-time employees
- Mental Health & Wellness Resources – Access to our Employee Assistance Program (EAP), Talkspace, and the Calm App.
- Life Insurance
- Short & Long-Term Disability Insurance
Financial Benefits:
- Retirement/Deferred Compensation Plans – Mason Health contributes 8% of your compensation every pay period when you contribute at least 5%.
- Flexible Spending Account (FSA)
- Tuition Assistance Program
- Approved by the Health Resources and Services Administration (HRSA) for student loan repayment programs.
Time Off & Work-Life Balance:
- Generous Paid Time Off (PTO) – Accrue up to 8 hours of PTO every bi-weekly pay period, starting with 5 weeks of PTO and increasing to 7 weeks after 3 years.
Exciting Incentive:
- Employee Referral Program – Earn up to $7,500 depending on the role.
Job Summary
- The Case Manager manages utilization reviews and coordinates case management. Performs concurrent admission and continued stay reviews. Contributes and assists in the performance of case management activities, and contributes to the assessing, planning, implementing, coordinating, monitoring and evaluating of the needs of patients for services both during and after hospitalization.
Job Specific Duties & Responsibilities
- Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using standardized criteria to achieve optimal patient outcomes and appropriate reimbursement for the hospital.
- Works with physicians regarding proper documentation and appropriateness of stay. Acts as a resource for staff in proper aspects of care. Works in conjunction with the House Supervisors to ensure accuracy of on-going patient status assignments.
- Provides clinical information requested by the managed care companies as part of the concurrent review in a timely fashion.
- Works collaboratively with physicians and managed care companies on concurrent denial appeals
- Performs focused assessment of needs for successful transition to home or other care settings. Collects data and contributes to goal-oriented care and treatment plan. Collects data from a variety of sources such as patient records, interviews, observation, and team members. Documents patient assessment and progress appropriately. Coordinates team-based care through effective partnerships with patients, their caregivers, and their providers. Communicates issues, variances and problems appropriately.
- Facilitates patient/family navigation through the healthcare system for assigned patients. May facilitate access to appropriate primary and specialty providers as well as other care coordination team support specialists (e.g. Diabetes Educators, Registered Dieticians).
- Serves as the point-of- contact, advocate, and informational resource for assigned patients, family, care team, payers and community resources. Proactively acts as patient advocate; responding with empathy and respect to resolve patient/family concerns.
- Functions as an active member of the Utilization Review/Medical Records Committee. Assists in periodic reviews, evaluations of Utilization Review policies and procedures.
- Supports continuing QA/QI at Mason Health and actively participates in all aspects of accreditation
- Participates in the development/implementing/in servicing and evaluation of standards of care/policies/procedures and protocols for the department of nursing.
- Other duties as assigned.
Required Education and Experience
- 3 years of related experience in a hospital setting.
- Bachelor’s Degree, preferred.
Required Licenses, Certifications and/or Registrations
- Registered Nurse License-Washington State
Mason Health practices equal employment opportunity towards all workforce members and applicants for employment. Mason Health does not engage in or tolerate any discrimination in the workplace prohibited by applicable local, state, or federal law. Specifically, no workforce member will be discriminated against on the basis of their race, color, sex/gender (including pregnancy), sexual orientation, religion/creed, age, disability, marital or veteran status, national origin, genetic information, or any other characteristic protected by applicable state or federal law.
Location: Mason Health · CaseMgt
Schedule: Days
Salary : $51 - $73
