Case Manager - Case Management

RN Case Manager

Position Summary

The case manager is responsible for individualized management of hospital and healthcare services necessary and appropriate to the provision of high quality, cost effective patient care. He or she works with acutely ill and/or high risk clients ranging in age from newborn to the geriatric population. The Case Manager develops collaborative, outcome-oriented plans of care for each patient, acts as a patient advocate and provides mechanisms and support to empower patients to make responsible healthcare decisions while guiding appropriate utilization of resources and services to achieve expected outcomes.

Responsibilities

• Determines appropriate level of care on admission using hospital approved medical necessity criteria
• Performs patient and care giver assessments to identify pertinent problems/needs
• Organizes assessment data into an individual plan of care, with anticipated outcomes
• Determines continued stay status
• Participates in multidisciplinary rounds
• Participates in patient education
• Tracks and manages potential avoidable hospital days
• Provides clinical information to external providers and managed care organizations
• Assists in discharge planning
• Assists in appeals and denials management

Requirements

• Graduate of an accredited school of nursing and licensed in the state of Ohio
• 2 years of clinical experience in an acute care setting
• Critical care/emergency department experience highly desired
• Knowledge of evidenced-based practice and disease management protocols
• Utilization review and or discharge planning experience preferred
• Excellent verbal and written communication skills
• Excellent computer skills
• LMH is accredited by DNV and TJC, and as such, may require specific annual education related to specialty certifications and standards.

Licking Memorial Health Systems is an equal opportunity employer and maintains compliance with all state, federal, and local regulations. Licking Memorial Health Systems does not discriminate against applicants because of race, color, religion, sex, sexual orientation, age, ancestry, national origin, veteran status, pregnancy, disability, marital status, or other characteristics protected by law.