RN Care Coordinator-Complex Case Manager

Requirements

• 3-5 years of diversified clinical experience is required, certification preferred
• A minimum of 2 years of previous experience involving judgment and decision making, preferably in a utilization management/case management position
• KNOWLEDGE AND SKILLS:
• A minimum of 3-5 years recent clinical experience required, and 1-3 years of recent acute, Inpatient Care Management experience required.
• Ability to understand confidentiality and the legal and ethical issues pertaining to patient health; understand medical terminology, how to obtain an accurate history; establish treatment goals; establish working relationships with referral sources; develop treatment plans.
• Knowledge and understanding of methods for assessing an individual's level of physical/mental impairment; understand the physical and psychological characteristics of illness; ability to assist individuals with the development of short- and long-term health goals.
• Ability to understand the requirements for prior approval by payer; be able to evaluate the quality of necessary medical services; be able to acquire and analyze the cost of care; understand the various health care delivery systems and payer plan contracts; be able to demonstrate cost savings.
• Ability to understand case management philosophy and principles; apply problem solving techniques to the care management process; document care management services; understand liability issues for care management activities.
• Knowledgeable on how to access and evaluate the available resources to meet a client's needs; able to develop new resources.
• Excellent interpersonal, verbal, and written communication and negotiation skills
• Strong analytical, data management and PC skills.
• Current working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.
• Understanding of pre-acute and post-acute venues of care and post-acute community resources.
• Strong organizational and time management skills, as evidenced by a capacity to prioritize multiple tasks and role components.
• Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.
• Ability to partner with post acute facilities to move patients to the next level of care that are considered long length of stay with difficult dispositions and possible insurance barriers
• Work with the Director and senior leadership team to come up with solutions for a patient to propose to senior leadership.
• And any other duties to be assigned by the hospital, department, or director
• Compensation Range:
• Equal Opportunity Employer/Disabled/Veterans

Benefits

Additional Information

Position: RN Care Coordinator-Complex Case Manager Department: Care Management Schedule: Full Time 10am-6pm

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Company Intel

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