RN Case Manager - Case Management

Licking Memorial Hospital; Newark (OH); On-site; USD 65,000 - 90,000; Full time

Job summary

The Case Manager at Licking Memorial Hospital in Newark, Ohio is responsible for individualized management of hospital and healthcare services to provide high quality, cost-effective patient care. The role serves acutely ill and high-risk patients from newborns to geriatrics, developing collaborative, outcome-oriented plans of care and advocating for patients while guiding resource utilization.

Responsibilities include determining level of care on admission, conducting assessments, organizing

Qualifications

• Graduate of an accredited school of nursing and licensed in Ohio.
• Minimum 2 years of clinical experience in an acute care setting.
• Critical care or emergency department experience preferred.
• Knowledge of evidence-based practice and disease management protocols.
• Utilization review or discharge planning experience preferred.

Responsibilities

• Determines appropriate level of care on admission using hospital approved medical necessity criteria.
• Performs patient and caregiver assessments to identify pertinent problems/needs.
• Organizes assessment data into an individual plan of care with anticipated outcomes.
• Determines continued stay status.
• Participates in multidisciplinary rounds.
• Participates in patient education.
• Tracks and manages potential avoidable hospital days.
• Provides clinical information to external providers and managed care organizations.
• Assists in appeals and denials management.

Skills

Communication skills

Care coordination

Assessment skills

Multidisciplinary collaboration

Education

Registered Nurse license - Ohio

Job description

The case manager is responsible for individualized management of hospital and healthcare services necessary and appropriate to the provision of high quality, cost effective patient care. He or she works with acutely ill and/or high risk clients ranging in age from newborn to the geriatric population. The Case Manager develops collaborative, outcome-oriented plans of care for each patient, acts as a patient advocate and provides mechanisms and support to empower patients to make responsible healthcare decisions while guiding appropriate utilization of resources and services to achieve expected outcomes.

Responsibilities

• Determines appropriate level of care on admission using hospital approved medical necessity criteria
• Performs patient and care giver assessments to identify pertinent problems/needs
• Organizes assessment data into an individual plan of care, with anticipated outcomes
• Determines continued stay status
• Participates in multidisciplinary rounds
• Participates in patient education
• Tracks and manages potential avoidable hospital days
• Provides clinical information to external providers and managed care organizations
• Assists in appeals and denials management

Requirements

• Graduate of an accredited school of nursing and licensed in the state of Ohio
• 2 years of clinical experience in an acute care setting
• Critical care/emergency departmentexperience highly desired
• Knowledge of evidenced-based practice and disease management protocols
• Utilization review and or discharge planning experience preferred
• Excellent verbal and written communication skills
• LMH is accredited by DNV and TJC, and as such, may require specific annual education related to specialty certifications and standards.

Licking Memorial Health Systems is an equal opportunity employer and maintains compliance with all state, federal, and local regulations.Licking Memorial Health Systems does not discriminate against applicants because of race, color, religion, sex, sexual orientation, age, ancestry, national origin, veteran status, pregnancy, disability, marital status, or other characteristics protected by law.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.