Registered Nurse RN - Case Manager
Registered Nurse RN - Case Manager - INTEGRIS Health - Oklahoma City Area
Great environment and full time employees enjoy excellent benefits to include retirement savings and personal paid leave!
Registered Nurse RN - Case Manager Position Overview: The Case Manager facilitates patient care during the hospitalization by managing, coordinating and monitoring resource utilization to achieve optimal clinical outcomes and financial goals. In general, the Case Manager functions in the role of clinician, educator, researcher, manager and advocate to serve the best interests of the system and patient. Adheres to National Patient Safety Goals as appropriate based on the level of patient contact this position requires. Responsibilities include, but are not limited to:
- Completes a comprehensive assessment of patients clinical, psychological and financial needs utilizing all available resources.
- Recommends and coordinates timely transfers to appropriate levels of care as indicated by clinical needs and utilization criteria.
- Develops, implements, evaluates and revises, as necessary, a plan for discharge, including referrals to other health care and community organizations based on needs assessment.
- Communicates discharge care plan, and any changes in the plan to patient, family and all appropriate healthcare professionals.
- Assists physicians and hospital staff in appropriate utilization of resources through application of utilization criteria and facilitating timely discharge planning for patients.
- Conducts concurrent review of patient records on admission to the hospital and as determined by the patient's clinical condition.
- Facilitates patient transfers to other health care organizations in accordance with hospital policies and all-applicable state and federal guidelines and regulations.
- Integrates and manages established pathways, where available, to enhance clinical effectiveness and clinical resource management.
- Maintains knowledge and understanding of CMS regulations, Medicare/Medicaid, managed care and other payer regulations and benefit limits.
- Acts as a resource and provides education for patients, their family members and all health care professionals regarding HCFA regulations, Medicare, Medicaid, managed care and other payers.
- Develops and maintains knowledge and understanding of hospital and community resources, and facilitates use of most appropriate level of care to conserve patient, hospital, and payer resources.
- Participates in collecting and recording data for utilization and Quality Improvement reporting.
Registered Nurse RN - Case Manager Position Qualifications:
- 5 years experience in a variety of clinical settings (e,g. home health, inpatient, physician office, clinic) required.
- Experience with managed care and payer/provider requirements preferred.
- Current licensure as a Registered Nurse (RN) in the State of Oklahoma or current multistate license from a Nurse Licensure Compact (eNLC) member state. BSN preferred.
- Current Drivers License issued by the state of Oklahoma.
Interested Candidates Please Contact:
Senior Healthcare Recruiter
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Please reference Position ID 165057 when responding.