Case Hardener Job Description Sample
Registered Nurse (Rn) Case Manager Per Diem - Case Management
This department works within other imaging departments to care for adult and pediatric patients who require sedation or anesthesia for their procedure. These nurses are an integral part of a multidisciplinary care team and are responsible for the assessment, planning, and care of the patient during interventional procedures. The areas of coverage include ultrasound, CT, Fluoro, EEG, Nuclear Medicine, Vascular Lab, and Echo. All nurses are required to have CPR, ACLS, and PALS certification. Experience in procedural sedation required. This department is scheduled Monday through Friday until 5PM and with weekend call until 5PM for emergencies.
Works with physicians and multidisciplinary team members to develop plan of care for each assigned patient from admission through discharge. Ensures patient is progressing toward desired outcomes by continuously monitoring patient care through assessment and/or evaluation. Assesses and responds to patient/family needs by coordinating efforts of other team members. Identifies and resolves barriers that hinder effective patient care. Improves quality and completeness of documentation.
Assesses, creates, implements evaluates and modifies timely discharge plans.
Collaborates with patients, families, nurse, physician and other members of the team, creating consensus around issues of discharge planning.
Documents in a clear, complete, concise, and organized manner.
Monitors clinically high risk and complicated cases and institutes necessary actions to promote quality care and appropriate integration.
Accepts referrals and identifies patients who meet the criteria for case management.
Coordinates cases between health care providers and insurance company.
Determines appropriate level of care according to InterQual criteria, and facilitate movement of patients in a timely manner.
Facilitates staffing and care conferences when indicated.
Develops treatment plan and discuss proposed course of treatment with patient's attending physician, patient, family and other members of the team.
Ensures patient/family/staff concerns are appropriately resolved in a timely manner.
Analyzes current operations, policies, systems, procedures, and develops and implements necessary and innovative changes.
Exhibits excellence in customer service through appropriate attitude and interaction with all patients, visitors and staff.
Adheres to and supports team members in exhibiting TMCH values of integrity, community, compassion, and dedication.
Assists with program planning, development, and evaluation.
Adheres to TMC organizational and department-specific safety, confidentiality, values policies and standards.
Performs related duties as assigned..
EDUCATION: Bachelor's degree in nursing.
EXPERIENCE: Three (3) years of nursing or case management experience.
LICENSURE OR CERTIFICATION: Current RN licensure permitting work in state of Arizona. Some departments may also require current CPR instructor certification, Neonatal Resuscitation Provider (NRP) certification.
KNOWLEDGE, SKILLS AND ABILITIES:
Knowledge of direct patient care and critical care procedures and techniques, tools, and responses required to ensure optimal patient care.
Skill in communicating in a clear and concise manner with staff involved in critical care, and physicians to ensure the proper care of patients.
Skill in evaluating cases and determining appropriate care and status.
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
Ability to write reports, business correspondence, and procedure manuals.
Ability to effectively present information and respond to inquiries or complaints from employees, patients and/or their representatives, and the general public.
Ability to calculate figures and compute rate, ratio, and percent and to draw and interpret bar graphs and apply basic algebraic concepts.
Ability to define problems, collect data, establish facts, and draw valid conclusions.
Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
RN / Registered Nurse , Case Manager - Case Management - Full Time - Days
Thank you for inquiring about a position with Paramount. We are a NCQA accredited managed care plan, which is part of ProMedica's integrated healthcare system with offices in Maumee, Columbus, Cleveland, and Cincinnati.
Paramount provides health insurance coverage for Medicare, Medicaid, and Commercial members. For more information about Paramount, please visit our website http://www.paramounthealthcare.com.
Our mission is to improve your health and well-being. So we're committed to your wellness with various initiatives, such as preventive services, online knowledge, health risk assessments, our Steps2Health disease management programs, health fairs, and more.
ProMedica Paramount in Columbus, Ohio is recruiting for RN Case Managers. The Case Manager assesses, plans, implements, coordinates, monitors and evaluates the ongoing care of a specific caseload through the Continuum of Care; collaborates with members of the health care team, members and their families to ensure effective, efficient and appropriate care during the entire episode of illness and for post-discharge services.
Further, this position monitors utilization and evaluates outcomes. This position reports directly to the Advantage Case Management Manager. No positions report to this position.
Assessment: Assess all referred "HMO/Advantage" members to determine case management needs by trigger diagnoses, disease management needs, high dollar cost, complex medical conditions or excessive length of stay.
Conduct a comprehensive health care plan review that includes member contact and PCP contact. Assess the member's functional status, decision-making ability, and psycho-social needs.
Enter identified "Advantage" members into Advantage Case Management with PCP and member consultation.
Planning: Plan a flexible care plan developed in conjunction with the member, PCP, health care team and other persons involved in the member's management.
The plan should address the member's health care needs identified in the assessment process. Community resources, psycho-social needs and end of life care are included in the plan of care.
Implementation and Coordination: Coordinate current treatment plans with the PCP and maximize benefits through in-Plan provider utilization.
Utilize cost benefit analysis. Ensure communication of goals with all health care team members. Coordinate psychological care with in-Plan providers and with Behavioral Health Case Management Coordinators.
Monitoring and Evaluation: Review the member's progress and conduct periodic reassessment of the care plan based on changing member needs.
Evaluate, initiate and coordinate case management members' potential discharge planning and follow-up needs.
Evaluate and manage resources and optimize reimbursement to ensure that members receive the most appropriate medical care in the most cost-effective setting.
Communication: Provide members and families with ongoing, current information and support to enhance satisfaction throughout the continuum of care. Facilitate communication among members of the health care team
Documentation: Documentation follows current Paramount procedures.
Has good knowledge of HMO/Advantage coverage, exclusions and Medicaid guidelines for appropriate system documentation. Demonstrates good skills in the required paper and electronic systems.
General: Act as a member advocate, maintain and ensure member privacy and confidentiality, adhere to ethical, legal and accreditation/regulatory standards for all Case Management activities/interventions. While most case management interaction is telephonic throughout the case management process as defined above, multidisciplinary face to face meetings with members and providers may be beneficial and necessary to effectively coordinate the member's treatment plan of care
Current Ohio Registered Nurse license required.
Valid driver license.
Certification in Case Management strongly preferred. If not certified, willingness to obtain certification when eligible and appropriate as deemed by manager.
Excellent communication (oral and written) and organizational skills required.
Demonstrated ability to plan, coordinate and organize multiple priorities.
Demonstrated PC skills, experience with electronic health record documentation.
Ability to move between company work stations and departments; ability to communicate on telephones and operate general office equipment, including computers.
Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex, pregnancy, sexual orientation, gender identity or gender expression, age, disability, military or veteran status, height, weight, familial or marital status, or genetics.
Equal Opportunity Employer/Drug-Free Workplace
Employee Exemption Type
Budgeted Hours / Pay Period
Additional Schedule Details
Case Manager - Case Management Department (20183408)
he case manager is a registered nurse who is responsible for providing case management services to assigned populations. He/she utilizes a collaborative interdisciplinary approach to anticipate, integrate, and coordinate the patient's plan of care, discharge plan and re-entry into the community.
The goal of his/her intervention is to meet the needs of patients to optimize clinical and resource outcomes and to monitor the effectiveness of the plan and its outcomes. The case manager serves as a patient/family advocate and acts as a communication link between the physician, patient, family, health care team, community resources and payers to reduce redundancy and fragmentation of care. He/she anticipates potential delays in the health care process and acts proactively to avoid these delays. The case manager ensures that the necessary services are provided at the most appropriate level of care and that there is a smooth progression of the patient through the healthcare system.
RN license in South Carolina or other compact state required. Requires strong organizational and interpersonal skills and the ability to think critically, problem solve, and to work independently. Excellent written and verbal communication skills are required.
Bachelor's degree in nursing preferred but not required.
South Carolina or other compact state Registered Nurse license required.
Case Management Certification preferred.
Prefer candidate to have 3 years of work experience in case management and discharge planning. Critical care nursing experience is highly recommended.
Team coordination or supervisory experience preferred. This candidate must possess strong organization and communication skills and can interact with a team. Experience with InterQual or MCG (Milliman) screening tools preferred.
Full-time, 80 hrs bi-weekly; 8am-4:30pm
RN Case Manager Inpatient - Case Management
Job Title: RN Case Manager Inpatient | Case Management | Fargo
State: North Dakota
Department : Case Management
Job Schedule: Full Time
Hours Per Shift: 8 hr
Provides expertise and leadership to ensure effective resource management for patient care delivery across the care continuum for assigned patient populations. With involvement of the patient/family, collaborates with licensed practitioners and other inter-professional team members to provide care coordination, transitional care planning, facilitation and coordination of discharge needs.
Enhances the quality of clinical outcomes and patient satisfaction while managing the cost of care. Promotes patient wellness through evidenced based practice, improved care outcomes, efficient utilization of health services, and appropriate level of care for patients during hospitalization and on a continuum after discharge. Provides discharge-planning education and makes referrals to inter-professional teams when necessary.
Initiates links with post-acute external care resources. Anticipates and/or identifies patient educational needs, discharge planning issues and effectively collaborates to expedite early discharge planning. Acts as an advocate for the patient, functioning in various care settings and across the continuum of care; achieving desired outcomes for both the clients and healthcare agencies.Responsible for utilizing the nursing process (assessment, diagnosis, outcomes/planning, implementation and evaluation) to provide individualized nursing care to patients.
Collaborates with other inter-professional colleagues, including physicians, to plan, implement and evaluate care. Demonstrates competency and practices within the full scope of nursing expertise/knowledge and utilizes appropriate age and population specific standards as designated in their assigned clinical setting. Cares for patients in all phases of preventative care, health maintenance, diagnosis, treatment, and follow-up as patients move along the continuum of care.
Responsible for the planning and coordination of care, patient assessment, patient, caregivers, and family education, triage, and various other nursing interventions. Functions within the scope and standards of nursing practice as outlined in the Nurse Practice Act and Administrative Rules in state of practice and licensure. The Sanford Professional Nursing Practice recognizes the Scope and Standards of Practice and the Code of Ethics for Nurses with Interpretive Statements as published by the American Nurses Association as the foundation of nursing care delivery and professional conduct.
Manages patient care and medical progress for a number of assigned patients. Managing multidisciplinary team members to develop a plan of care for assigned patients.
Developing monitoring processes and methods to ensure selected patients are progressing towards desired results, e.g. assessments and evaluations. Follows best practices to solve barriers that impede effective patient care. Maintaining ongoing contact with other health providers to ensure effective implementation of a healthcare plan. Develops, implements and documents discharge plans for patients; utilizes resources and facilities to meet the needs of patients transferring between a hospital or skilled nursing facility and a home environment.
8-430-5/7-4-430 and a potential intermittent weekend.
Currently holds an unencumbered RN license with the State Board of Nursing where the practice of nursing is occurring and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state. Incumbent must obtain and subsequently maintain required department specific competencies and certifications including Basic Life Support (BLS) within 60 days of hire.
Certification in: Case Management (CCM), Care Coordination and Transition Management (CCCTM), or holds a certification in their patient population specialty that they serve, is encouraged when eligible. Graduate from a nationally accredited nursing program required, including, but not limited to, Commission on Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN), and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Bachelors Degree in nursing required, or in the process of acquiring degree, and a completion date within five years upon date of hire into position. Minimum of 3 years of clinical nursing experience required.
About Sanford Health:
At Sanford Health, we are dedicated to the work of health and healing.
Every day, we show that commitment by delivering the highest quality of care to the communities we serve.
We are leaders in health care and strive to provide patients across the region with convenient access to expert medical care, leading-edge technologies and world-class facilities.
In addition to strong clinical care, we are also committed to research, education and community growth.
We engage in medical research to not only discover innovative ways to provide care, but also cures for common diseases.
We continuously seek new ways to achieve our vision of improving the human condition here in your community,
across the region and around the world.
The entire team at Sanford Health recognizes the value of healthy families and communities.
We continue to gain momentum and expand our reach. Together, we can make a positive difference now, and in the future.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application,
please call 1-877-673-0854 or send an email to firstname.lastname@example.org .
In compliance with federal law requiring employers to verify new employees' U.S.
employment eligibility, Sanford participates in E-Verify. To learn more click here for English Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterEnglish.pdf or here for Spanish Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterSpanish.pdf .
State: North Dakota
Job Function: Nursing
Job Schedule: Full Time
Req Number: req20524
Case Manager, RN - Case Management
Founded in 1938, Wilcox Medical Center is the largest medical facility on Kaua'i and has been recognized as one of the nation's best rural hospitals. With 169 physicians on staff, Wilcox provides residents and visitors with expert diagnosis and treatment for more than 20 specialties.
Its state-of-the-art acute care facility includes a full suite of services from emergency, OB/GYN and pediatrics to cardiology, gastroenterology, ophthalmology, pulmonology, nephrology, cosmetic surgery, internal medicine and family practice. In 2010, the Wilcox Health Women's Center opened to provide preventive and diagnostic care for Kaua'i's women close to home. The hospital has 71 beds, including seven intensive care beds, five birthing suites, 20 same-day surgery beds and a 20-bed emergency department.
It is equipped with MRI and CT scanners and a state-of-the-art surgical center with six surgical suites. In 2010, the American Heart Association recognized Wilcox Memorial in three areas of excellence: Coronary Artery Disease (Gold Award), Stroke (Silver Award) and Heart Failure (Silver Award.) Wilcox Memorial Hospital, together with Kaua'i Medical Clinic and the Wilcox Health Foundation, is affiliated with Hawai'i Pacific Health, the state's largest health care provider.
The Case Management team puts great emphasis on helping each patient transit their health care treatment with an appropriate set of support tools and information. Our caring, professional staff provides timely medical and discharge management to meet clinical and service goals, and to provide an effective, appropriate continuum of care. We want to ensure that our patients receive the attention they need, especially when they require care from several different services and other combinations of medical, financial or social intervention.
As the RN Case Manager, you will ensure the considerate and confidential management of unique and high-risk patient cases by performing case management through direct referrals and reviews of medical records. This includes determining the appropriateness and medical necessity of admissions, continued hospital stay, and the use of ancillary services.
You will also perform treatment plan assessments, discharge needs interviews, planning/coordination for high risk cases, and participate in organizational quality improvement activities. We are looking for someone perceptive to patient needs, with outstanding organizational and communication skills and a commitment to delivering the highest quality health care to Hawai'i's people.
Location: Wilcox Medical Center, Lihue, HI
Work Schedule: Day/Evening - 12 Hours
Work Type: Full Time Regular
Bargaining Unit: Non-Bargaining
Current Hawai'i Registered Nurse license.
Bachelor's degree and/or equivalent combination of education, training and experience. Three (3) years recent acute care registered nurse experience in Pediatrics, OB/GYN, or with Adults, and/or relevant experience.
Current Hawai'i Registered Nurse License.
Knowledge of criteria based review. Strong organization, analytical, and planning skills.
Position Case Manager, RN - Case Management
Employment Type Employee
Location Wilcox Medical Center, Lihue, HI
Req ID 10496
Director Case Management
???????????????? Utilization Review, Case Management and Transition Management
??? Provides leadership and oversight to department leaders and staff.
??? Responsible for the development, communication, and successful execution of established financial and non-financial objectives as articulated through the organizational structure and strategic plans.
??? BSN required, Master???s preferred or currently enrolled
??? 2 years Acute Care Experience, CCM preferred
??? Relocation and competitive salary
??? For profit system
Assumes primary responsibility for directing the Case Management Department, its processes and functions. Collaborates with allied health professionals to promote and ensure that quality care is provided and outcomes are achieved in a timely and cost-effective manner.
Utilizes an interdisciplinary process to assess, plan and provide patient care for specific diagnoses from pre-admission through aftercare. Assists in organizing internal processes and systems to prevent avoidable hospital days. Promotes appropriate post-hospital utilization of resources, adequate education of patient and hospital staff, and decreased incidence of re-admissions.
Director Case Management
In this position you will:
Promote and support the mission, vision and objectives of Saint John???s Health Center and is responsible and accountable for the clinical, fiscal, and personnel management of Case Management on a 24 hour, 7 day basis.
Develops and utilizes mechanisms for directing, evaluating and controlling operational activities towards accomplishments of division effectiveness and efficiency. Develops collaborative relationships with physicians and all departments. Participates in the development of strategic plans and programs.
Assures compliance with all state and federal laws and other regulatory requirements, in all areas of responsibility.
Required qualifications for this position include:
Graduate of a recognized registered nurse program.
RN with current license in the State of California.
A minimum of 5 years direct patient care experience.
Minimum of 3 years supervisory experience.
Preferred qualifications for this position include:
Master???s degree in Nursing or other related field preferred.
Master???s Business or Healthcare Administration
Expertise in application of InterQual criteria and Case Management software products, e.g., McKesson InterQual.
??? Minimum 3 years of acute care clinical experience.
??? Minimum of 2 years Clinical Case Management/Utilization Review experience (preferred)
??? Theoretical knowledge of the nursing process, case management and continuity of care
??? Ability to maintain adequate physical and mental health to meet job performance standards
??? Advanced assessment and teaching skills.
??? Motivation for self-direction
??? Ability to exercise supervisory skills and demonstrate leadership
??? Able to relate and work with chronically ill and disabled patients of all ages, and with emotionally upset, and at times hostile people within the facility.
??? Able to relate and work with various managed care representatives, defining the continuing need for medical treatment.
??? Speak and read English fluently.
??? Current RN license by the Pennsylvania state board of nursing
??? Certified Case Manager (CCM) preferred
Must have strong computer skills for documentation
Ability to operate within different databases (including Excel)
Director Case Management
Full-time DaysNo WeekendsPOSITION SUMMARY:Coordinates hospital-wide case management functions including assessment, improvement activities, regulatory and accreditation surveys and compliance, appropriate admissions/status, and length of stay. Collects and reviews data from internal and external sources to evaluate the quality of case management functions in collaboration with the medical staff, departmental directors and hospital leadership.
Retrieves, communicates, and presents information in a written auditory, visual fashion, as needed. Responsible for overall collaborative coordination, with leadership members, for hospital-wide case management activities, and coordination of care. Collaborates with department managers, senior leadership, and employees through assessment of patient learning needs and discharge planning, designing, implementing and evaluating case management activities.
EXPERIENCE REQUIRED OR PREFERRED:5 to 8 years related case management experience. Minimum of 3 years hospital acute care case management experience. Successful leadership/management experience within matrixed, corporate organizations.SKILLS, KNOWLEDGE, AND ABILITIES:Demonstrated success and abilities in leadership, achieving results, communications, customer service and health care management.Demonstrates assertive and diplomatic communication skills with a leadership style that initiates engagement, collaboration and direction with clearly defined expectations.
Demonstrated results in the implementation of length of stay reduction and accountable reporting through metrics.EDUCATION REQUIRED AND/OR PREFERRED:Graduate of an accredited school of nursing as an RN. BSN preferred.MSN, MBA or Master???s degree in related field preferred;LICENSURE/CERTIFICATION:RN license in the State of Florida.CCM Certification is preferred.
RN Director Of Consolidated Case Management
The Registered Nurse (RN) Director of Case Management is responsible for the clinical oversight of case management.?? Collaborates to continually improve the process of assessment, planning, facilitation, care coordination, evaluation, discharge planning and advocacy for options and services to meet the patient and family comprehensive health needs.?? Duties also include the implementation and monitoring of processes to ensure the reduction of extended length of stay (LOS), readmission and appropriate patient level of care status within the facility.?? Collaborates with the department Directors/Managers and Physicians to support appropriate documentation as it relates to quality, patient care and safety.?? Develops and coordinates processes to improve staff effectiveness and efficiencies related to UR, discharge planning, CM and physician/staff satisfaction.?? The Registered Nurse (RN) Director of Case Management will serve as a resource specialist/consultant, responsible to assess, conduct and evaluate formal clinical reviews/audits to achieve regulatory readiness and organizational compliance with local, state and federal agencies.?? Utilizes communication and available resources to promote quality cost effective outcomes.?? Engages in standardizing a care coordination model throughout the facility, with ongoing metrics for evaluation and improvement of patient care.??
SKILLS AND CERTIFICATIONS??[note: bold skills and certification are required]
Current NV RN Registered Nurse License??
5 or more years previous supervisory experience
Bachelors Degree, or enrolled in a program
7+ to 10 years experience
Seniority Level -??Director
Management Experience Required -??Yes
Minimum Education -??Associate's Degree
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