RN Case Manager - Utilization Management - FT Days
Location: LITTLE ROCK, ARKANSAS, UNITED STATES
Requisition #: 2019-R0255794
Post Date: 10 hours ago
Position Type: Regular
Scheduled Hours per 2 week Pay Period: 80
Primary Location: AR > LITTLE ROCK > ST VINCENT INFIRMARY
JOB SUMMARY: The case manager coordinates the care and service of selected patient populations across the continuum. He/she works collaboratively with physicians and other members of the health care team to achieve the highest quality clinical outcomes with the most cost effective use of available resources. The case manager assumes responsibility for an interdisciplinary process which assesses, plans, implements, monitors and measures the effectiveness of interventions to meet patients' treatment and transitional needs. The case manager provides services to neonate, pediatric, adolescent, adult and geriatric patients and demonstrates the knowledge and skills necessary to offer care appropriate to the age of the patient.
I. Resource Management
A. Collaborates with the physician and other health care professionals to promote appropriate use of medical center resources.
B. Uses severity of illness/intensity of services indexes to determine appropriateness of admissions, transfers and continued stays;
C. Advocates for adherence to best practice standards through use of approved guidelines, protocols and order sheets;
D. Provides physicians and ancillary departments with data on treatment outcomes and avoidable delays in order to promote highest quality care;
E. Communicates and negotiates with outside agencies, including insurance carriers, in order to obtain needed services for patients and accurate reimbursement for medical center;
F. Takes a leadership role in identifying opportunities to reduce risks, both financial and clinical, through analysis of resource consumption outcomes.
II. Transitional Planning
A. Works with interdisciplinary team to coordinate needed services to ensure efficient continuity of care.
B. Assesses need for services through collaboration with physicians and nursing staff;
C. Plans for care needs with active involvement of patient, significant others, hospital staff involved in treatment process;
D. Oversees implementation of transition plans with support from internal and external agents;
E. Monitors patients' progress and adequacy of planning process through regular communication with patients and service providers;
F. Documents actions in medical record according to departmental guidelines and oversees process of exchange of information with other facilities/agencies adhering to legal mandates about confidentiality;
G. Measures effectiveness of interventions through direct communication with patients and caregivers and data collection of defined indicators (e.g., overall length of stay, readmission rates, feedback from referral sources, etc.).
H. Identifies problems or gaps in community resources that impact outcomes and takes leadership role in efforts to effect changes.
III. Advocacy for Quality Outcomes
A. Acts as a patient advocate for optimum care and a business partner to the physician.
B. Participates as a team member to facilitate communication among all disciplines, identify barriers to meeting treatment goals, and determine ways to achieve best outcomes;
C. Provides information and support to patients and families, helping them access needed resources within the medical center and community;
D. Assists physicians in obtaining needed services for their patients and having access to all available data on best practice and financial outcomes;
E. Cultivates collegial partnerships with physicians and other health care professionals and maintains high customer satisfaction ratings in dealing with patients and their significant others;
F. Demonstrates innovative problem-solving skills and ability to analyze and organize data to provide evidence for necessary process changes.
IV. Professional Development
A. Takes responsibility for adhering to case management standards of practice, hospital and departmental policies and procedures, and for professional development.
B. Performs all assigned tasks according to standards defined by the Case Management Society of America and other relevant professional groups;
C. Promotes a safe and effective work environment by following institutional
guidelines for work activities, reporting any variances to department director immediately.
D. Participates actively in relevant educational programs and shares information with other members of department and health care team;
E. Maintains knowledge base about relevant clinical and fiscal issues and about community resources.
F. Participates actively in staff meetings, designated medical center committees and community groups/task forces.
G. Takes an active role in appraisal process, documenting achievements and defining goals for self and department annually.
H. Collaborates with other case managers to ensure effective and efficient operations, using effective communication skills to share information and constructive feedback.
Education: Registered Nurse with Bachelors degree or associates degree with case management certification (CCM or ACM)
Preferred: Masters degree & case management certification (CCM or ACM)
Licensure: Current, state licensure
Experience: Minimum - one year in acute care hospital
Preferred - experience in case management, discharge planning or utilization management role
Recommended skills: Familiarity with case management role in health care setting
Knowledge of medical terminology, utilization management criteria, community resources, and health care reimbursement systems
Ability to analyze data, apply critical thinking process to problem-solving
Demonstrated capacity to work with inter- disciplinary team (especially physicians) and communicate effectively
Your time at work should be fulfilling. Rewarding. Inspiring. That's what you'll find when you join one of our non-profit CHI facilities across the nation. You'll find challenging, rewarding work every day alongside people who have as much compassion as you. Join us and together we'll create healthier, stronger communities. Imagine your career at
As a Registered Nurse, you will be responsible for delivering the highest quality patient care according to the specific orders of each patient's individual physician. This will involve, utilizing your knowledge and skills to educate patients and their families on prevention and healthy habits.
Additional responsibilities for this health care role include:
- Monitoring patients' conditions and assessing their needs
- Collaborating with physicians and nurses to devise individualized care plans for patients
- Administering patients' medications and providing treatments according to physicians' orders
- Fostering a supportive and compassionate environment to care for patients and their families
We are looking for a responsible and compassionate Registered Nurse with top-notch clinical skills, a caring attitude, and the ability to work independently with minimal supervision. It is also important to display excellent verbal and written communication and interpersonal skills as well as the ability to effectively educate patients and their families on the in-home healthcare process.
Additional requirements for this role include:
- Current Registered Nurse (RN) license that allows you to practice in our state
- Graduate of an accredited nursing program
- Experience as a Registered Nurse preferred
- Basic Life Support (BLS) required
- Specialty certification (ex: CCRN, CNOR, CEN) preferred
- Additional certification or licensure may be required for some specialty areas
- Requisition ID: 2019-R0255794
- Schedule: Full-time
- Shift: Day Job
- Market: CHI St. Vincent
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Chances are, you're here because you're looking for a career offering greater opportunity, challenge and fulfillment. We're confident you'll find all three at CHI. As one of the nation's largest nonp