CASE MANAGER

Premier-Health-62e0a015; Ohmer Park (OH); On-site; USD 47,000 - 63,000; Part time

Benefits offered by this job

Flexible part-time schedule

On-site hospital role

Job summary

Premier Health's Miami Valley Hospital seeks a part-time Case Manager RN to assess patient needs, coordinate care, and plan transitions across the hospital and care continuum. The role emphasizes interdisciplinary collaboration, payer liaison, and adherence to care guidelines.

A BSN and an Ohio RN license are required, with preferred experience in reimbursement and clinical documentation. The successful candidate will demonstrate strong interpersonal and negotiation skills, knowledge of

Qualifications

• BSN degree required.
• Registered Nurse license for Ohio.
• Experience in case management preferred.
• Clinical documentation management experience preferred.
• Knowledge of reimbursement requirements and transition planning preferred.

Responsibilities

• Assess patient needs and coordinate care across hospital and care continuum.
• Facilitate interdisciplinary team collaboration and communication with family/c payer.
• Plan transitions to promote appropriate length of stay and resource use.
• Utilize clinical guidelines and performance data to improve outcomes.
• Manage caseload and document activities in clinical systems.

Skills

Interpersonal skills

Negotiation

Conflict resolution

Assertive communication

InterQual ISD-A

Milliman guidelines

Third-party insurance knowledge

Information gathering

Monitoring indicators

Basic computer skills

Education

BSN degree

Ohio RN license

Tools

Clinical documentation system

InterQual ISD-A

Milliman guidelines

Job description

General Summary/Responsibilities:Status: Part-time: *48h per pay periodShift: 0830-1700Facility: Miami Valley HospitalThe 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: BSN required.Licensure: Registered Nurse with valid Ohio license.Certification: Certification in area of clinical specialty preferred.Experience: Minimum of three years of relevant clinical experience in area of patient population within last five years. Expertise in healthcare reimbursement, transition planning and case management preferred. Experience with a clinical documentation management program preferred, knowledge of performance improvement process preferred.Skills/Other: Exemplary interpersonal skills as demonstrated by the ability to develop and maintain rapport with physicians and Integrated 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. Experience in gathering information, monitoring indicators and feedback mechanisms required. Basic computer skills required.