Case Manager RN

Case Manager Registered Nurse

Knowledge, Skills & Abilities:

Under the supervision of the Case Management Director, the Case Management Registered Nurse coordinates the overall interdisciplinary plan of care for a patient, from admission to discharge. Identifies and intervenes when necessary to ensure efficient and cost-effective delivery of patient care services. Establishes and promotes collaborative relationships with physicians, patients, families and additional members of the healthcare team. Educates members of the healthcare team on case management and managed care concepts. Anticipates the needs of customers and works proactively to improve services. Must be a registered nurse with 3-5 years of clinical experience.

Projects a professional demeanor and appearance while maintaining the confidentiality of patients, coworkers, and facility information and adhering to the HIPAA policy. Reports, in good faith, any known or suspected activity that appears to violate laws, rules, regulations or the SP Code of Conduct. Fulfills annual Cornerstone/Connect-U continuing education requirements.

Personal attributes include the ability to be self-directed; demonstrates accountability, professionalism, and receptiveness to change; seeks guidance, direction, and assistance when needed. Works under stress and in situations that demand patience, stamina, endurance, and tact while providing impeccable service. Fosters an attitude of teamwork and willingness to assist others and does not refuse performing other job duties as requested. Sets priorities, responds timely to issues which require a decision, and ensure desired results are achieved by means of consistent follow through.

Patient Population:

The patient population served by South Texas Spine & Surgical Hospital is a minimum of 12 years and/or of adult stature to geriatric patients requiring or seeking pain and/or surgical intervention.

Physical Requirements:

May be expected to lift up to 10 - 20 pounds occasionally. Work is of light demand; walking, standing and sitting most of the time while on duty. Visual and auditory acuity and manual dexterity essential to performing designated duties required. Optimal auditory acuity required. Manual dexterity involving the handling of office equipment is essential to performing assigned duties. Physical conditions are clean, neat and well lit. Climate control and ambient temperature variances may be experienced. Hours of duty may be irregular or unexpectedly extended due to the requirements of the job.

OSHA Exposure Classification:

Job Category I. Direct contact with blood or other body fluids to which standard precautions apply. Personal protective equipment is made available and must be worn.

• Demonstrates eligibility for employment in the U.S.
• Graduate of a school of professional nursing with current and valid licensure with Texas State Board of Nursing as a Registered Nurse.
• BLS prerequisite.
• Diploma or Associate's in Nursing/related health care field required or an established plan to obtain a Bachelor's Degree preferred
• 2 - 3 years of nursing experience in a hospital
• Is aware of professional nursing standard and performs in accordance with them.
• Knowledge of commonly used concepts, practices, and procedures within a particular field.
• Knowledge of state, federal and accrediting body regulations and standards related to healthcare. (CDC Guidelines, Joint Commission Standards)
• Ability to relate and work effectively with others.
• Ability to read, write and communicate effectively in English, with additional languages preferred.
• Demonstrates ability to comprehend written and oral instructions.
• Willingness to participate in goal-setting and educational activities for his/her own professional advancement and that of others.
• Must be computer literate with basic fundamental computer skills that are required to perform essential job-related duties.

PEOPLE

1. Facilitates the development of appropriate working relationships with facility administrators, departmental leaders and employees
2. Demonstrates effective verbal and written communication skills keeping staff informed
3. Demonstrates skills as a team player and works closely with the managers to establish positive relationships
4. Educates staff on regulatory requirements related to discharge planning and utilization review

SERVICE

1. Participates in Employee Orientation as appropriate
2. Assists with direct patient care if the need develops and maintains practice at acceptable level to perform duties of Registered Nurse associated with background and experience
3. Models appropriate interaction with staff to ensure high level of service in all areas of responsibility
4. Provides educational opportunities to clinical staff
5. Plans for specific needs of patients in-house and post-discharge.
6. Coordination of all aspects of patient's case management needs, reimbursement and DME needs.

QUALITY

1. Assists with collection and analysis of organizational metrics
2. Assists with collection and analysis of quality indicators
3. Work demonstrates accuracy and thoroughness
4. Stays abreast of Joint Commission Standards, Texas Department of State Health Services and CMS Regulations for discharge planning and utilization review

FINANCE

1. Prevents readmissions by working with external resources and patients
2. Work is completed in a cost-efficient manner
3. Performs other administrative duties as required

GROWTH

1. Provides staff education activities based on needs assessment/leadership requests
2. Willingness to take on additional assignments to assist others in the facility
3. Keeps abreast of current developments
4. Pursues opportunities for continuing education
5. Seeks personal nursing certification or educational opportunities
6. Supports requirements of accreditation process

OTHER DUTIES

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

• 2 year(s): 2 years of hospital case management or care coordination experience

• Associates or better in Nursing

• Bachelors or better in Nursing

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.