Case Manager RN

Company: MyMichigan Health
Location: Alpena
Posted on: March 17, 2023

Job Description:

Summary

General Summary



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 role.






Essential Duties & Responsibilities

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• (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 available resources.
  
  
• (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:
  
  
  
  
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  • 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:
    
    
    
    
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    • 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 position.
      
      
    • 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 assisted device(s).
      
      
    • Frequently required to sit/stand/walk for long periods of time.
      
      
    • May require frequent postural changes such as stooping, kneeling or crouching.
      
      
    • Some exposure to blood borne pathogens and other potentially infectious material.
      
      
    • 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 stay awake.
      
      
    • Overall dexterity is required including handling, reaching, grasping, fingering and feeling.
      
      
    • May require repetition of these movements on a regular to frequent basis.
      
      
    • 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