Case Manager - RN

The Case Manager - RN manages patients’ overall interdisciplinary care plans, from admission to discharge. Ensures that the plan of care is medically necessary, timely, coordinated, facilitated, and effectively communicated to the physician, healthcare team, and patient to improve quality, safety, satisfaction, and effective discharge planning. 

Duties/Responsibilities:

• Collaborates with the patient and healthcare team regarding target length of stay, acute care criteria, payer requirements, and care options to meet patient needs, including participation in multidisciplinary rounds and case conferences.
• Coordinates appeal process according to payer guidelines.
• Identifies and resolves system problems, barriers, and delays that impede the plan of care, discharge, or reimbursement. 
• Assures direct, purposeful flow of communication to keep patient and all health care team members on track toward discharge.
• Expedites care, follow up on diagnostic studies and reports, and overcome barriers to prevent delays.
• Collaborates to assure early identification, ongoing assessment, and intervention for post-hospital care needs.

Education:
Associate’s Degree in Nursing (ADN) required. Bachelor’s Degree in Nursing (BSN) preferred.

Experience: 
Five years nursing experience in an acute care setting required. Nursing leadership experience preferred. Case Management/Utilization Review experience preferred.

Licensure/Certification: 
Valid Kentucky Board of Nursing (KBN) license required.

Physical/Work Requirements: 
The physical demands described here represent those that an employee must meet to perform the essential functions of this job successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is regularly required to sit and use hands to finger, handle, or feel. The employee is required to communicate with staff, patients, and visitors. Specific vision abilities this job requires include close vision for reading and computer work.  The employee must regularly lift and/or move up to 10 pounds, frequently lift and/or up to 50 pounds, and occasionally lift and/or move more than 100 pounds.  The employee is regularly required to stand, walk, and be on foot for long periods. Must be able to tolerate PPE for long periods.

The work environment described here is representative of those that an employee must meet to perform the essential functions of this job successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee works in an area with good lighting and climate control. The noise level in the work environment is usually moderate.