Case Manager

St. Mary's Health Care System; Athens (GA); On-site; USD 65,000 - 90,000; Full time

Job summary

The Case Manager at St. Mary’s Health Care System collaborates with a multidisciplinary team to evaluate patient needs from admission in the acute care setting through return to the community for a defined caseload.

Responsibilities include chart reviews for utilization review and identifying follow-up needs to prevent delays. They coordinate discharge planning, leverage community resources, and communicate with external agencies to smooth transitions and ensure accurate diagnosis documentation

Qualifications

• Current GA RN license.
• Graduate of an accredited school of nursing; BSN recommended.
• Minimum 2 years' nursing experience and 1 year in case management, utilization management, or discharge planning preferred.
• Certification in case management preferred.
• Excellent communication, interpersonal, and critical thinking skills.

Responsibilities

• Implement interdisciplinary process for evaluating options and services from admission to return to the community for a specific caseload.
• Conduct initial and concurrent chart reviews for utilization review and identify follow-up needs.
• Identify patients requiring case management follow-up and coordinate with care team.
• Identify and alert physicians of actions to reduce delays and length of stay.
• Initiate discharge planning and coordinate transitions to post-hospital settings; communicate with external agencies for referrals.

Skills

Communication skills

Interpersonal skills

Critical thinking

Education

RN licensure (GA)

BSN recommended / Accredited nursing school graduate

Job description

Description

The Case Manager, in collaboration with other healthcare professionals, is responsible for implementing an interdisciplinary process for evaluating the options and services required to meet an individual’s health care needs from admission to the acute care setting through return to the community for a specific caseload of patients. The case manager is also responsible for conducting initial and concurrent chart reviews for the purpose of utilization review as well as identifying patients requiring case management follow-up. This includes a biopsychosocial assessment of the case management patients, their response to treatment, identifying and alerting the physicians of possible actions to reduce delays associated with extended stays. The case manager enhances cost-effective use of resources by identifying and initiating discharge planning to accomplish the timely transition of patients to a post-hospital setting. The case manager must have in depth knowledge of system and community resources and referral agencies. The case manager is responsible for communicating with external agencies to provide referrals information for a smooth transition from hospital to the post-hospital setting. This includes communication with other health care agencies and payer sources. This position will also assure proper identification of principal and secondary diagnosis in collaboration with the treating physician.

Employment Type

Full time

Shift

Day Shift

Description

The Case Manager, in collaboration with other healthcare professionals, is responsible for implementing an interdisciplinary process for evaluating the options and services required to meet an individual’s health care needs from admission to the acute care setting through return to the community for a specific caseload of patients. The case manager is also responsible for conducting initial and concurrent chart reviews for the purpose of utilization review as well as identifying patients requiring case management follow-up. This includes a biopsychosocial assessment of the case management patients, their response to treatment, identifying and alerting the physicians of possible actions to reduce delays associated with extended stays. The case manager enhances cost-effective use of resources by identifying and initiating discharge planning to accomplish the timely transition of patients to a post-hospital setting. The case manager must have in depth knowledge of system and community resources and referral agencies. The case manager is responsible for communicating with external agencies to provide referrals information for a smooth transition from hospital to the post-hospital setting. This includes communication with other health care agencies and payer sources. This position will also assure proper identification of principal and secondary diagnosis in collaboration with the treating physician.

Position Requirements

A: Licensure/Certification/Registration: Current GA RN license

B. Education: Must be a graduate of an accredited school of nursing, BSN recommended

C: Experience: Must have a minimum of 2 years' experience in nursing and a minimum of 1 year in case management, utilization management, or discharge planning preferred.

Certification in case management preferred.

D: Special Qualifications: Excellent communication, interpersonal, and critical thinking skills.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.