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 docmentation 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 Director of Quality/Case Management. Performs other duties as assigned.
DescriptionMinimum RequiredPreferred / DesiredExperience
Diploma or Associate Degree in Nursing
Bachelor's in Nursing
2 years of clinical experience
3 years of clinical experience with Case Management experience in a hospital or payer setting
.Critical thinking skills, communication, organization, interpersonal and computer skills. Knowledge of payer requirements; problem solving; and governmental regulations.Critical thinking skills, communication, organization, interpersonal and computer skills. Knowledge of payer requirements; problem solving; and governmental regulations.
Preferred: ACM , CCM ,