CASE MANAGER

PHP Staging Mobile Taleo; Dayton (OH); On-site; USD 85,000 - 110,000; Full time

Job summary

Miami Valley Hospital North seeks a compassionate RN Case Manager to lead individualized patient assessment, care coordination, and transition planning across the hospital stay and beyond.

Requires BSN, Ohio RN license, 3+ years clinical experience; familiarity with InterQual ISD-A, Milliman guidelines, and discharge planning. Join a multidisciplinary team to optimize outcomes and resource use. Full-time day shift with weekend rotation every fourth weekend.

Qualifications

• Graduate from an accredited school of nursing; BSN required.
• Valid RN license with the State of Ohio; relevant certifications preferred.
• Minimum of three years of clinical experience in the patient population.
• Knowledge of InterQual ISD-A and Milliman Guidelines and third-party insurance requirements.

Responsibilities

• Coordinate patient care and transition planning to promote optimal outcomes.
• Facilitate interdisciplinary team collaboration and liaison with patient, family, physician, payor.
• Lead discharge planning, resource allocation, and care coordination across the health care continuum.

Skills

RN license Ohio

Interpersonal skills

Team collaboration

Education

BSN required

Tools

Microsoft Office

Job description

CASE MANAGER(

Job Number:

Description

Position: Case Manager (RN)

Dept: Integrated Care Management Program

Shift: Full Time 8:30am -5pm / 80 Hours per Pay & every 4th weekend requirement

Facility: Miami Valley Hospital North

The Case Manager is a registered nurse responsible for individualized patient assessment and care coordination, and transition planning to promote maximal outcomes in relation to appropriate length of stay, effective use of resources and established guidelines of care. Additional responsibilities include facilitation of interdisciplinary team collaboration, liaison between the patient, physician, payor, family/significant others in regards to care coordination and transitional care needs. This position requires expertise in acute care nursing, healthcare reimbursement requirements, clinical outcome data analysis, utilization management, transition planning and process, resource allocation, team management and communication skills.

Promotes care coordination and effective utilization of resources through the assessment of patient care needs during the hospitalization and across the health care continuum. Success is measured against achievement of targeted goals and outcomes as generated by defined expectations through care team collaboration.

Qualifications

Education: Graduate from an accredited school of nursing; BSN Required.

Licensure/Certification/Registration: Valid RN license with the State of Ohio; Certification in area of clinical specialty (case management, neuro, critical care, rehab) preferred.

Experience: Minimum of three years of relevant clinical experience in area of patient population within the last five years. Experience with clinical documentation management program preferred. Expertise in healthcare reimbursement, discharge planning and case management preferred.

Knowledge/Skills:

• Exemplary interpersonal skills as demonstrated by the ability to develop and maintain rapport with physicians and Integrative Care Team members.


• Negotiation skills, conflict resolution skills and assertive communication skills required.


• Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred,


• Knowledge of Microsoft Office is required

Primary Location

: OHIO-DAYTON-MIAMI VALLEY HOSPITAL NORTH

Work Locations

:
MIAMI VALLEY HOSPITAL NORTH
9000 N MAIN ST
DAYTON 45415-118

Shift Hours : 0830-1700 Shift Length : 8 Hour Shift Length Budgeted Hours (per pay) : 80