RN Case Manager - Case Management

LMHS brand; Newark (OH); On-site; USD 60,000 - 80,000; Full time

Job summary

LMHS brand in Newark, Ohio seeks a Case Manager to coordinate hospital and healthcare services, advocate for patients, and guide utilization of resources to achieve quality outcomes.

You will assess patients and families, develop individualized care plans, participate in rounds, and support discharge planning in an acute care setting.

Candidates should be a graduate of an accredited nursing program, licensed in Ohio, with at least two years of acute care experience and strong communication skills.

Qualifications

• RN license in Ohio and graduate of an accredited nursing program.
• Minimum 2 years of clinical experience in an acute care setting.
• Critical care or emergency department experience highly desired.
• Knowledge of evidence-based practice and disease management protocols.
• Utilization review or discharge planning experience preferred.
• Excellent verbal and written communication skills.
• LMH is accredited by DNV and TJC; annual education for specialty certifications may be required.

Responsibilities

• Determines appropriate level of care on admission using hospital criteria.
• Performs patient and caregiver assessments to identify problems/needs.
• Organizes data into an individualized plan of care with outcomes.
• Determines continued stay status and participates in rounds.
• Participates in patient education and discharge planning.
• Tracks avoidable hospital days and communicates with providers.
• Provides clinical information to external providers and managed care.
• Assists in appeals and denials management.

Skills

Verbal communication

Written communication

Care coordination

Utilization review

Education

RN license in 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.