Overview and Responsibilities
Promotes patient-centered care among the healthcare team by providing coordination, collaboration and clinical expertise to meet patient needs and achieve optimal outcomes. Promotes prudent utilization of all resources. Serves as the patient's advocate by coordinating resources and services necessary to meet the patient's continuing care needs. Reviews and evaluates medical documentation with physicians and other healthcare members to support compliance and external regulatory requirements and to improve outcomes of care. Assists in Performance Improvement activities by identifying, monitoring and reporting quality measures, and participating in quality improvement teams. Communicates and utilizes policies that support patient's fundamental right to considerate care, protects their personal dignity and respects their cultural, psychosocial and spiritual values in an effort to meet patient care needs and preferences. Reports to the Supervisor of Case Management/Director of Quality/Case Management. Performs other duties as assigned.
Experience Description: None *** Experience Minimum Required: RN with professional practice experience in an acute care setting or the educational equivalent. *** Experience Preferred/Desired: RN with three (3) years experience in acute care setting. Experience in a payer environment is highly desirable. Case management certification preferred or be in the process of obtaining. *** Education Description: None *** Education Minimum Required: None *** Education Desired/Preferred: None *** Training Description: None *** Training Minimum Required: None *** Training Desired/Preferred: None *** Special Skills Description: None *** Special Skills Minimum Required: Advanced communication, conflict management, organizational and planning skills. Advanced computer literacy skills. *** Special Skills Desired/Preferred: None *** Licensure Description: Must have appropriate state licensure and/or certification. RN *** Licensure Minimum: RN *** Licensure Preferred: CCM,ACM
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