The Nurse Case Manager focuses on the coordination of patient care across the continuum to assure quality outcomes, utilization/resource management, discharge planning, and patient and family satisfaction. The Nurse Case Manager is an advocate for the patient and collaborates with medical, nursing and other health care disciplines to improve patient outcomes.
Required: High school diploma or Associate degree in Nursing
Required: 3-5 years experience in a clinical/hospital setting
Preferred: 2-5 years experience in case management
Required: Excellent written and verbal communication, critical thinking and problem solving skills, organization/time management and prioritization; negotiation and collaboration; and computer skills a must.
Preferred: Knowledge of CMS and other governmental rules and regulations and/or application of InterQual criteria
Required: Current RN licensure in the state of Texas
Complete initial and ongoing case management assessment specific to psychosocial and discharge planning needs of patient and family/significant others across the age continuum.
Identify discharge needs of patients/family/significant other related to current illness, functional status, financial status, etc. in order to coordinate post acute referrals in a timely, responsive manner.
Communicate effectively with patients/families and other members of the healthcare team related to discharge plans in order to ensure a smooth and timely transition to the next level of care.
Completes timely and thorough documentation in meditech and in ECIN in order to communicate collaboratively with all members of the healthcare team.
Comply with hospital and department policies and procedures in order to be compliant with quality and regulatory standards.
Coordinate interdisciplinary team conferences in order to develop collaborative treatment goals, care plans and discharge plans for patients.
Determine medical necessity by using InterQual criteria, in conjunction with EHR (Executive Health Resources) on admission and concurrently during hospital stay.
Performs other duties as assigned to meet the organization`s needs.