Performs evaluation in multiple environments including process and relationships, health care management, community resource and support, service delivery, psychosocial intervention and rehabilitation.
The successful candidate has proven leadership skills and knowledge of state regulatory requirements and URAC. The RN Case Manager will work Monday through Friday during normal business hours in a comfortable and modern professional office environment.
Participates in data collection and analysis of clinical outcomes of care and customer satisfaction standards. Participates in the formulation and implementation / monitoring of action strategies and outcomes of care or customer service.
The CM will coordinate with the health care team and the patient/family to address payer issues that impact care, and to develop a transition plan of care that includes a safe discharge plan and plan for follow up with care providers post discharge.
In this nursing role, you take responsibility for the complete ongoing care of each patient to ensure their home dialysis treatment stays on track; provide comprehensive patient care in an independent setting.
The RN Case Manager II assesses, develops, implements, coordinates and monitors a comprehensive plan of care for each patient/family in collaboration with the physician, social worker and all members of the interdisciplinary team in the inpatient and emergency department patient care areas.
Responsible for ensuring the continuity of care in both the inpatient and outpatient setting utilizing the appropriate resources within the parameters of established contracts and patients health plan benefits.
Interpersonal skills necessary to interact effectively with members of the interdisciplinary team, including physicians and external health care professionals, to achieve desired clinical, service and financial outcomes.