Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes.
The RN Transitional Care Case Manager utilizes research findings in practice and participates in Transitional Care program design, implementation and evaluation and participates in ongoing quality improvement activities and collects clinical path variance data that indicates potential areas for system wide improvement of cares and services provides identifying errors and discrepancies in care that negatively impact the patient and seeks to rectify them through a broader system approach.
Evaluates and coordinates medical and rehabilitative services using cost containment strategies. Plans a proactive course of action to address issues presented to enhance the injured employees short and long-term outcomes.
Work telephonically and in the field with patients identified as high risk to identify needs, set goals and implement action steps towards achieving goals. Empower patients to help them improve their quality of life.
Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes.
This case manager is responsible for the development, planning, coordination, and administration of functions including activities such as utilization review, discharge planning, social services and resource management, including daily review of medical records to determine appropriateness and medical necessity of admissions, continued hospital stay, and use of ancillary services.
As a RN Case Manager, your ability to manage client care with specific knowledge and experience in bedside care, symptom management, crisis intervention and family intervention are feature assets for this high-profile nursing position.
The RN Case Manager utilizes a collaborative process of assessment, planning, implementation and evaluation, to engage, educate, and promote/influence members decisions related to achieving and maintaining optimal health status for our Americas International membership.
The Care Coordinator works collaboratively with all members of the multi disciplinary team to ensure patient needs are met and care delivery is coordinated across the continuum, as well as appropriately reimbursed by payers as contracted.