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.
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.
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.
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.
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.