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Maria Parham Health RN-Case Manager

Job Summary The RN Case Manager is responsible for the coordination of clinical care, quality, and financial outcomes of a designated population of patients. The RN Case Manager is responsible for overseeing an efficient plan that will ensure continuity and effective community or post-acute reentry. The RN Case Manager leads the interdisciplinary team in developing complex discharge plans. Reports to: Director Case Management FLSA: Non-exempt Grade: EEO: □ 01 Officials and Managers X 02 Professionals □ 03 Technicians □ 04 Sales Workers □ 05 Administrative Support Workers □ 06 Craft Workers □ 07 Operatives □ 08 Laborers and Helpers □ 09 Service Workers

Job Requirements

Minimum EducationAssociate’s degree in nursing required.Bachelor's degree in nursing preferred.

Required SkillsLicenses:Current/active North Carolina or compact RN license required.AHA Basic Life Support (BLS) required.Case Management Certification, preferred Critical thinking skills, decisive judgment, and the ability to organize and prioritize workload to meet deadlines with minimal supervision.Must possess excellent interpersonal skills to interact with all levels of healthcare providers, support staff, and third-party payors where appropriateExcellent computer skillsMust possess excellent interpersonal skillsRequires a working knowledge of community resources and Utilization/Quality Review standards and activities conducted by third party payors

Minimum Work Experience5 years recent acute care hospital experience, requiredSupervisory experience, preferredHospital case management experience strongly preferred

Nonessential Functions other duties as assigned**

Functional Demands

Populations Served□ Does not treat or care for patients.X Neonate (<30 days)X Infant (<1 year)X Early Childhood (1 year and <5 years)X Late Childhood (5 years and <13 years)X Adolescent (13 and <17 years)X Young Adult (17 to <30 years)X Middle Adult (30 years to <60 years)X Older Adult (>60 years)

Protected Health InformationType of Protected Information Accessed:DemographicClinicalInsuranceFinancialX Complete Medical Record

Bloodborne Pathogens ExposureWhile performing this job, occupational exposure is present for all employees

Physical Requirements - Physical Dexterity and Effort: Rarely <1%, Occasionally 1-33%, Frequently 34-66%, Constantly 67-100%Bending/Stooping X rarely, □ occasionally, □ frequently, constantlyClimbing X rarely, □ occasionally, □ frequently, □ constantlyKeyboard Data Entry □ rarely, □ occasionally, X frequently, □ constantlyKneeling X rarely, □ occasionally, frequently, □ constantlyLifting/Moving Patients □ rarely, X occasionally, frequently, □ constantlyReaching □ rarely, □ occasionally, X frequently, □ constantlyRepetitive Foot/Leg Movements □ rarely, □ occasionally, X frequently, □ constantlyRepetitive Hand/Arm Movements □ rarely, □ occasionally, X frequently, □ constantlyRunning X rarely, □ occasionally, □ frequently, □ constantlySitting □ rarely, X occasionally, □ frequently, □ constantlySquatting □ rarely, X occasionally, □ frequently, □ constantlyStanding □ rarely, □ occasionally, X frequently, □ constantlyWalking □ rarely, □ occasionally, X frequently, □ constantlyPushing / Pulling: 0-25 lbs. □ rarely, □ occasionally, X frequently, □ constantlyPushing / Pulling: 26-75 lbs. □ rarely, □ occasionally, X frequently, □ constantlyPushing/Pulling: over 75 lbs. □ rarely, □ occasionally, X frequently, □ constantlyLifting/Carrying (non-patient) : 0-25 lbs. □ rarely, □ occasionally, X frequently, □ constantlyLifting/Carrying (non-patient) : 26-75 lbs. □ rarely, X occasionally, □ frequently, □ constantlyLifting/Carrying (non-patient) : over 75 lbs. X rarely, □ occasionally, □ frequently, □ constantly

Visual Acuity, Hearing and Speaking: Rarely <1%, Occasionally 1-33%, Frequently 34-66%, Constantly 67-100%Audible Speech □ rarely, □ occasionally, □ frequently, X constantlyHearing Acuity □ rarely, □ occasionally, □ frequently, X constantlySmelling Acuity X rarely, □ occasionally, □ frequently, □ constantlyTaste Discrimination X rarely, □ occasionally, □ frequently, □ constantlyVision: Depth Perception □ rarely, □ occasionally, X frequently, □ constantlyVision: Distinguish Color □ rarely, □ occasionally, X frequently, □ constantlyVision: Seeing Far □ rarely, X occasionally, □ frequently, □ constantlyVision: Seeing Near □ rarely, □ occasionally, □ frequently, X constantly

Biological: Rarely <1%, Occasionally 1-33%, Frequently 34-66%, Constantly 67-100%Biohazardous waste/ hazards □ rarely, X occasionally, □ frequently, □ constantlyBlood and/or bodily fluids □ rarely, □ occasionally, X frequently, □ constantlyCommunicable diseases/pathogens □ rarely, X occasionally, □ frequently, □ constantly

Chemical: Rarely <1%, Occasionally 1-33%, Frequently 34-66%, Constantly 67-100%Asbestos or lead X rarely, □ occasionally, □ frequently, □ constantlyCytotoxic Chemicals X rarely, □ occasionally, □ frequently, □ constantlyDust X rarely, □ occasionally, □ frequently, □ constantlyHazardous Chemicals □ rarely, X occasionally, □ frequently, □ constantlyGases/Vapors/Fumes □ rarely, X occasionally, □ frequently, □ constantlyHazardous Medication □ rarely, X occasionally, □ frequently, □ constantlyLatex □ rarely, □ occasionally, X frequently, □ constantly

*Organizational Expectations *

Maria Parham Health is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual’s age, color, disability, genetic information, gender, gender identity, national origin, race, religion, sexual orientation, or veteran status.

Provides a positive and professional representation of the organization.

Promotes a culture of safety for patients and employees through proper identification, reporting, documentation, and prevention.

Maintains hospital and clinic standards for a clean and quiet patient environment to maintain a positive patient care experience.

Maintains competency and knowledge of current standards of practice, trends, and developments in related scope of role or practice.

Maintains compliance with organization's policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards.

Complies with organizational and regulatory policies for handling confidential patient information.

Demonstrates excellent customer service through his/her attitude and actions, consistent with the standards contained in the Vision, Mission, and Values of the organization.

Adheres to professional standards, hospital policies and procedures, federal, state, and local requirements, and TJC standards and/or standards from other accrediting bodies.

* Essential Functions

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Facilitates patients care plan as called for in the plan of care

Leads daily discussions regarding patients regarding patients’ progression along the continuum

Works collaboratively as a leading member of the health team to ensure appropriate use of hospital resources, patient satisfaction, and achievement of quality of care, manages input from all healthcare professionals and conducts assessments to determine patient’s healthcare and transitional needs

Evaluates and ensures appropriateness of admissions and continued stay using evidence based criteria

Collaborates and manages outcomes with the payers through ongoing written and verbal communications through appropriate parties

Leads discussions with MDs and physician advisors about safe plan for transitions

Leads the team to ensue appropriate utilization of patient and hospital resources and directs care to other settings when appropriate

Collaborates with community case managers and other health care advisors to ensure a smooth and safe continuum of care plan

Conducts extensive assessments and implements interventions for patients at risk for readmissions

Manages concurrent denials and works with physicians to overturn for appropriate reimbursement

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Job: *Case Management/Social Services

Organization: **

Title: RN Case Manager

Location: NC-Henderson

Requisition ID: 7460-9110