CASE MANAGER

System Support; Dayton (OH); On-site; USD 75,000 - 95,000; Full time

Job summary

Miami Valley Hospital North seeks an experienced Registered Nurse Case Manager to lead individualized assessments and care coordination. You will oversee transition planning to optimize outcomes, length of stay, and resource utilization within the Integrated Care Management Program.

The role requires acute care nursing expertise, Ohio RN licensure, and BSN, with preferred certifications in case management or specialty areas. Strong communication with care teams and families is essential.

Qualifications

• BSN required and Ohio RN license in good standing.
• Certification in case management or related fields preferred.
• Minimum of three years of relevant clinical experience in the last five years.

Responsibilities

• Assess patients and coordinate individualized care plans.
• Plan transitions and discharge to optimize length of stay and resources.
• Collaborate with interdisciplinary team and liaise with patient, physician, payor and family.
• Support utilization management and adherence to care guidelines.
• Document clinical information and participate in care coordination across the continuum.

Skills

Interpersonal skills

Negotiation

Conflict resolution

Assertive communication

Microsoft Office

Education

BSN

RN license (Ohio)

Tools

Microsoft Office

Job description

Position: Case Manager (RN)Dept: Integrated Care Management ProgramShift: Full Time 8:30am -5pm / 80 Hours per Pay & every 4th weekend requirementFacility: Miami Valley Hospital NorthThe 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.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