License and Certification:
- Must be qualified to independently complete an assessment within the scope of practice of his/her discipline (for example, RN, SW, OT, PT, ST, and Rehabilitation Counseling).
- If licensure is required for his/her discipline within his/her state, individual must hold an active license.
- Current CCM® or ACM certification is required or must be obtained within one year of being placed in the position.
Education, Training and Years of Experience:
- For Nursing, must possess baccalaureate degree in Nursing (BSN) with RN licensure.
- For other eligible health care professionals, must possess a minimum of a baccalaureate degree and graduate degree is preferred.
- 3 years of hospital based Case Management experience including Utilization Review and Discharge Planning experience.
Machines, Equipment Used:
- General office equipment such as telephone, copy machine, fax machine, calculator, computer
- Good visual acuity and ability to communicate.
- Ability to lift, lower, push, pull, and retrieve objects weighing a minimum of 30 pounds. Reasonable assistance may be requested when lifting, pushing, and/or pulling are undertaken which exceeds these minimum requirements.
- Adheres to the company's Standards of Business Conduct.
- Maintains current licensure and/or certifications, if applicable
Skills and Abilities:
- Strong leadership skills.
- Strong negotiation skills.
- Must have a working knowledge of regulations and contractual obligations and parameters of third-party reimbursement.
- Must demonstrate skill in administrative functions of accountability, decision-making and time management, in addition to providing direct case management services to patients.
- Ability to speak, read, write, and communicate effectively.
- Ability to coordinate, analyze, observe, make decisions, and meet deadlines in a detail-oriented manner.
- Ability to work independently without supervision.
- Indoor, temperature controlled, smoke-free environment. Occasional outdoor exposure
- Exposure or potential exposure to blood and body fluids may be required
- Handicapped accessible
- May work under stressful circumstances at times
Proficiency or Productivity Standards:
- Meets established attendance standards.
- Adheres to hospital/department dress code including wearing ID badge.
- May be required to work weekdays and/or weekends, evenings and or night shifts if needed to meet deadlines.
- May be required to work on religious and/or legal holidays on scheduled days/shifts.
- Will be required to work as necessary during disaster situations, i.e., before, during or after a disaster.
- May be required to stay after workday to assist after a disaster situation until relief arrives.
- May be required to perform other duties as assigned by supervisor.