RN Case Manager Inpatient-Care Coordination
US-NM-Albuquerque
Careers (External)
Req #: 48125
Type: Part-Time1
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Overview: Now hiring a Case Manager-Inpatient-Care Coordination Coordinating patient care across the continuum using assessment, care planning, implementation, coordination, monitoring and evaluation for cost effective and quality outcomes in a primarily inpatient setting How you belong matters here. We value our employees' differences and find strength in the diversity of our team and community. At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members. Why Join Us * Part Time (.45 to .89) - Exempt: Yes * Job is based at Presbyterian Hospital * Work hours: Varied Days and Hours * Benefits: PRN/PT (working less than a .45 FTE) employee benefits available for this position such as medical, gym memberships and an employee wellness program. Ideal Candidate: Bachelors degree. RN license required. Five years experience in clinical nursing. A minimum of two years of recent experience in acute clinical, utilization review, or case management within the last 10 years. Responsibilities: * Identifies and advocates for members in caseload, referring to appropriate inpatient, outpatient and community resources including care coordination * Conducts an in-depth assessment which includes, psychosocial, physical, medical, environmental and financial parameters. Collaborates with Healthcare team to proactively develop, implement and document treatment and discharge plan with appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs * Collaboratively formulates, implements, coordinates, monitors, and evaluates strategies with the healthcare team to address care management issues for specific patients and disease processes * Applies utilization review criteria to assess and document the appropriateness of admission, continued stay, level of care, and readiness for discharge; refers cases that do not meet criteria to designated Physician Advisor. Promotes the appropriate use of clinical and financial resources in order to improve quality of care and patient/member satisfaction * Performs cost-benefit analyses and negotiates rates with providers and vendors. Interfaces and negotiates with insurance companies and other payers to ensure payment for services. Generates reports, which demonstrate efficacy through direct cost-savings and outcome measures * Actively participates in the development of clinical guidelines and pathways and incorporates processes into the role of nurse care coordinators * Educates providers and other PHS/PHP departments on health management strategies and care coordination services * Performs other functions as required. Qualifications: * Bachelors degree in Nursing, Business, or Health related field preferred. RN license required. * Five years experience in clinical nursing. * A minimum of two years of recent experience in acute clinical, utilization review, or case management within the last 10 years. * National certification preferred within 3 years of hire. * Computer knowledge to include Windows, Word, Excel, and database systems. * Ability to analyze trends based on decision support systems. Business management skills to include, but not limited to, cost/benefit analysis, negotiation, & cost containment. * Knowledge in referral coordination to community & private/public resources
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