CASE MANAGER SUPPORT

Premier Health Partners; Troy (OH); On-site; USD 65,000 - 90,000; Full time

Job summary

Premier Health Partners’ Upper Valley Medical Center seeks a Nurse Care Manager to coordinate patient care under the Integrated Care Management team. The role emphasizes discharge planning, utilization and case management, and collaboration with physicians and families to ensure quality, cost-effective outcomes.

The ideal candidate holds a BSN, an active Ohio RN license, 3–5 years acute care experience, and strong communication and analytical skills to support care coordination and workload

Qualifications

• Professional nursing knowledge and BSN; licensure.
• Current Ohio RN license is required.
• 3–5 years acute care experience with utilization/case management.
• Strong interpersonal skills to support patients, families, and staff.
• Analytical and problem-solving abilities; basic computer skills.

Responsibilities

• Review patient records for discharge planning and care management.
• Coordinate and monitor care across the continuum.
• Participate in risk management and quality measures.
• Mentor and support other care management staff.

Skills

Nursing theory

BSN

RN license

Utilization management

Case management

Interpersonal skills

Analytical skills

Computer skills

Education

BSN degree

Tools

MS Word

MS Access

Job description

Facility: Upper Valley Medical Center
Under the general supervision of the Manager of Integrated Care Management, the Care Manager works collaboratively with the Care Management Team to interact with patients/families and healthcare providers to insure that cost effective, quality care is provided throughout the continuum of healthcare. He/She assesses, implements, coordinates, monitors, evaluates and communicates options/services needed to meet the individual’s healthcare needs, thus promoting quality & cost effective outcomes. The Care Manager provides a timely review of the patient’s medical record for care management activities, including but not limited to: discharge/transition planning, clinical documentation, utilization management issues (recidivism/length of stay, care delays and avoidable days), admission/continued stay reviews, addressing status issues, providing severity/intensity of illness criteria for CMS and third party payers, and make referrals to Social Services, Home Care Liaison, and Patient Education). He/she participates in risk management and quality measures: recidivism, core measures, missing H&Ps, post-operative note, etc. The Care Manager is in direct contact with patient/family/providers, participates in daily “huddles” on unit for purpose of care coordination and identification of possible barriers to discharge, and actively supports patient and physician satisfaction goals. The Care Manager also mentors and acts as a resource to other health care providers in care management techniques and quality issues. Patients may range in age from newborn to an elderly patient population based on specific assignments.

• Professional knowledge of nursing theory and practice at a level normally acquired through completion of a nursing degree at an accredited School of Nursing. Additional nursing continuing education preferred. BSN required.
• Current Ohio State license as a Registered Nurse required.
• Three to five years of recent acute care experience in combination with/or with knowledge of utilization and case management principles.
• Interpersonal skills necessary in order to instruct and comfort patients and their families, and maintain effective contacts with a variety of hospital personnel. Recognizes and reinforces positive efforts of all co-workers.
• Analytical skills necessary for problem solving and conflict resolution.
• Ability to learn basic computer skills. Word and Access experience preferred.