Case Manager - Care Management

Legacy Health; Ridgefield (WA); On-site; USD 74,000 - 112,000; Full time

Job summary

Legacy Health in Ridgefield, WA seeks a dedicated Case Manager (RN) to advocate for patients facing difficult situations, coordinating with healthcare teams to ensure care, comfort and dignity. You will guide transitions across the continuum—inpatient, outpatient, home health and hospice—while identifying barriers to self-care and educating patients and families with health-literate communication.

A BSN or higher is preferred and current RN licensure is required; certification in case management

Qualifications

• Academic degree in nursing (BSN or higher) preferred.
• Minimum 2 years clinical nursing experience required; knowledge of disease management.
• Experience coordinating community resources and care management.
• Knowledge of care levels across inpatient to home health and hospice.
• Knowledge of CMS guidelines and Interqual criteria.
• Strong organizational and communication skills.

Responsibilities

• Coordinate and facilitate interdisciplinary, patient-centered care across the continuum.
• Foster optimal health care outcomes within standards of care.
• Serve as expert resource on care continuum, resources, best practices and regulatory requirements.
• Ensure smooth transition of care with planned handoffs.
• Partner with patients and families to identify issues and barriers to self-care.
• Use health literacy guidelines to educate on self-management.
• Monitor and report progress of interventions and outcomes via quality cycles.
• Pace care to assure appropriate and fiscally sound coordination.

Skills

Excellent organizational skills

Health literacy

Transitional planning

Patient/family engagement

Regulatory compliance

Keyboard skills

Education

BSN or higher

Job description

Overview

You are the voice, the coordinator and the empathetic advocate of patients facing difficult situations. Your compassion for patients and families with acute and chronic health conditions knows no limits. You are committed to working with healthcare teams to ensure every patient receives the care, comfort and dignity they deserve. If this is how you define your role as a Case Manager, we invite you to consider this opportunity.

Responsibilities

• Coordinates and facilitates interdisciplinary provision of comprehensive, patient-centered, quality health care throughout the continuum for patients with acute and chronic health conditions.


• Fosters achievement of optimal health care outcomes within accepted standards of care.


• Serves as an expert resource to the healthcare team regarding the continuum of care, efficient use of resources, Best Practice protocols, team-based care, quality indicators and improvements, and regulatory requirements.


• Ensures a smooth transition of care between multiple health care environments with planned handoffs.


• Partners with patients and families in identifying health care issues and barriers to self-care in order to set priorities and engage in appropriate interventions.


• Demonstrates cultural agility and employs health literacy guidelines to provide education regarding self-management strategies.


• Utilizes rapid quality improvement cycles to continuously monitor, evaluate, measure, and report progress of interventions and outcomes.


• Paces the case to assure appropriate and fiscally sound care coordination across the continuum.

Qualifications

Education:

• Academic degree in nursing (BSN or higher) preferred.

Experience:

• This position requires extensive knowledge of disease management to include diagnostics, treatment and prognosis, community resources and healthcare reimbursement. Minimum 2 years clinical nursing experience required. Relevant experience in one or more of the following healthcare areas preferred:
  
  
  
  • Coordination of community resources
  
  
  • Care management of diverse patient populations
  
  
  • Ambulatory Care
  
  
  
  


• Knowledge of levels of care throughout the health care continuum to include; inpatient, emergency care, rehab, home health, hospice, long term acute care, SNF, ICF, ALF with an overall understanding of utilization management and resource management.


• Working knowledge of Care Management models across the continuum.

Knowledge/Skills:

• Knowledge of six core components of case management:
  
  
  
  • Psychosocial aspects
  
  
  • Healthcare reimbursement
  
  
  • Rehabilitation
  
  
  • Healthcare management and delivery
  
  
  • Principles of practice i.e. CMS guidelines, Interqual criteria
  
  
  • Case Management concepts
  
  
  
  


• Excellent organizational skills


• Health literate oral and written communication skills for effective interaction with all members of the patient’s health care team


• Knowledge of transitional planning to and from all venues


• Ability to determine and access appropriate community resources


• Ability to engage patient/family in discussion of health care goals and decisions with attention to cultural and health literacy implications


• Ability to adhere to and implement regulations in an effective manner. Must serve as a resource to all team members regarding regulatory issues.


• Keyboard skills and ability to navigate electronic systems applicable to job functions.

Licensure

• Current applicable state RN licensure.


• Case management certification preferred.


• BLS for Healthcare Providers from the American Heart Association required for all employees who perform this job in the state of Oregon.

Pay Range

USD $54.37 - USD $81.21 /Hr.

Our Commitment to Health and Equal Opportunity

Legacy Health is an equal opportunity employer and prohibits unlawful discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion or creed, citizenship status, sex, sexual orientation, gender identity, pregnancy, age, national origin, disability status, genetic information, veteran status, or any other characteristic protected by law.