Case Manager /RN

The Case Manager acts as a resource to providers regarding discharge planning, medical record documentation, and all issues that may affect resource utilization and reimbursement.

Responsibilities include:

Concurrent review to include assessment of patient's clinical, psychological, and financial needs to negotiate efficient movement of the patient throughout the continuum of care. Social Services clinical consults (WHC/Family Med) when needed in absence of Social Worker Case Manager or refer to covering Social Worker. Discharge planning for all patients. Swing Bed Rules and regulations as well as operations. Constant monitoring of utilization of hospital services. Utilization review phone calls. Responsible for department functions in the absence of the Case Management Director. Perform utilization management, discharge planning and resource management in accordance with state and federal guidelines and hospital policies and procedures. Act as a case management consultant to all disciplines. Perform other duties as requested or assigned.

QUALIFICATIONS EDUCATION

Participates in mandatory in-services and continuing education programs as mandated by policies and procedures, accreditation, or licensing agencies and as directed by the Department Director.

LICENSE / CERTIFICATION / REGISTRATION

Current Kansas RN license or ability to obtain licensure, per Kansas State Board of Nursing regulations. CARE Assessment Certification through KDADS. Certification in Case Management preferred but not required. BLS - Obtains RQI BLS certification within appropriate quarter (approximately within 3 months of hire), maintains quarterly RQI requirements.

EXPERIENCE

One year experience as a RN staff in a hospital setting preferred. Knowledge of community services preferred. Knowledge of MCG criteria preferred Computer experience required.