Case Manager RN
Company: MyMichigan Health
Posted on: March 17, 2023
The RN Case Manager plays a pivotal role in maintaining the quality
of care patients receive during medical centerization and post
discharge while ensuring the organization is fully reimbursed. The
RN CM must have a high level of expertise and skill to create
highly effective strategies for short term and long term goals in
order to prevent re-admissions and address unpredictable
situations. CM must be proficient in planning, executing and
monitoring effectiveness of the care provided to ensure timely
transition through the continuum of care. Educating and consulting
with the physician and the healthcare team to ensure accuracy of
medical necessity criteria and to ensure timely and appropriate
level of care is achieved. This requires effective skills in
conflict resolution, decision-making and team building. The Nurse
Case Manger practices in accordance with the care management
process utilizing tools, standards, models, goals and objectives,
and performance improvement concepts. The Nurse Case Manager
provides pertinent clinical data to outside agencies as needed to
assure compliance with their requirements and represents the
organization professionally. The ability to analyze, evaluate and
distribute resources and educational information to ensure
understanding of services to all educational level is key to the
Essential Duties & Responsibilities
- (30%)* Work with healthcare team, patient, family and/or
significant others to continually transition the patient to the
appropriate level/place of care. Advocate, mediate, and negotiate,
with an emphasis on self-determination for the patient system, to
formulate a cohesive plan for maintaining the patient's health
status, improving social supports, and moving the patient safely
into less restrictive, less costly levels of care according to
- (20%)* Collaborates with all members of the Care Management
Team including physicians, nurses, medical social workers, health
information analysts, and others to provide information relating to
admission, continued stay, discharge criteria, managed care,
federal program regulations, reimbursement fundamentals, and
regulatory standards on a daily basis.
- (20%)* Actively participate in care coordination efforts to
successfully identify high-risk factors and respond appropriately
so that key information, next steps and available days are captured
and documented. Is able to lead, with the case management team,
daily care coordination meetings.
REQUIRED EDUCATION, EXPERIENCE, TRAINING AND SKILLS:
- Education: Associates Degree
- Preferred Education: Bachelor's degree in nursing at time of
hire or transfer to position preferred.
- RN - Registered Nurse required
- Three to five years clinical experience. MidMichigan Health is
a technology driven organization and employees need to demonstrate
competency in Microsoft Windows. An employee may be required to
participate in further learning opportunities offered by
MidMichigan Health. Certification in case management preferred.
Recommend that the Case Manager receives their ACM certification
after two years of experience.
PHYSICAL/MENTAL REQUIREMENTS AND TYPICAL WORKING CONDITIONS:
- Exposure to stressful situations, including those involving
public contact, as well as, trauma, grief and death.
- Able to wear personal protective equipment that includes latex
materials or appropriate substitute if required for your
- Is able to move freely about facility with or without an
assisted device and must be able to perform the functions of the
job as outlined in the job description.
- Overall vision and hearing is necessary with or without
- Frequently required to sit/stand/walk for long periods of
- May require frequent postural changes such as stooping,
kneeling or crouching.
- Some exposure to blood borne pathogens and other potentially
- Must follow MidMichigan Health bloodborne pathogen and TB
testing as required.
- Ability to handle multiple tasks, get along with others, work
independently, regular and predictable attendance and ability to
- Overall dexterity is required including handling, reaching,
grasping, fingering and feeling.
- May require repetition of these movements on a regular to
- Physical Demand Level: Sedentary.
- Must be able to occasionally (0-33% of the workday) lift or
carry 0-10 lbs.
Keywords: MyMichigan Health, Flint , Case Manager RN, Executive , Alpena, Michigan
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