Under supportive supervision, the Case Management Nurse I position supports the physician and interdisciplinary team in the provision of patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers. The role integrates and coordinates utilization management, transitions of care, and discharge planning functions. The Level I RN Case Manager is accountable for a designated patient caseload and plans effectively in order to ensure patients receive the right care in the most appropriate setting, manage the length of stay, and promote efficient utilization of resources.

Core Competencies

• Adheres to policies, procedures, and standards of practice to deliver safe and optimal care
  
  
• Complies with Joint Commission’s national patient safety goals
  
  
• Complies with organizational quality dashboard/benchmarking goals
  
  
• Maintains regulatory compliance consistent with quality standards and ethical obligations of the profession
  
  
• Participates in activities in alignment with the Magnet Model
  
  
• Participates in organizational committees, task forces and/or projects including presentation of project reports, committee recommendations, and task force activities at the unit level.
  
  
• Participates in Peer Review
  
  
• Participates in professional development activities
  
  
• Performs as a preceptor in an active and engaged manner
  
  
• Provides patient and family education throughout the care of patient
  
  
• Provides age specific and culturally competent discharge planning to all patients.
  
  
• Utilizes resources in an economical manner
  
  

Department Specific Competencies

• Assesses, analyzes, synthesizes data gathered and develops an initial discharge plan.
  
  
• Collaborates/communicates with the multidisciplinary care team throughout the continuum of care.
  
  
• Ensures appropriate utilization management by analyzing and synthesizing clinical documentation, and collaborating with the multidisciplinary team to ensure patients are receiving the right care, in the right place at the most appropriate level of care.
  
  
• Establishes the patient/family/case manager relationship and determines their readiness to engage in the discharge planning process.
  
  
• Maintains a working relationship with ancillary departments, external case managers and post-acute care providers.
  
  
• Screens / identifies patients that may benefit from professional case management services.
  
  
• Uses critical thinking to formulate and carry out a discharge plan according to the patient’s needs.
  
  
• Utilizes the Electronic Health Record to ensure timely, accurate and complete documentation of assessments, referrals, and variances in care.
  
  

Education

DegreeProgramAssociatesNursing

Experience

Number of Years ExperienceType of Experience1Recent Acute Case Management experience5Nursing Clinical experience
Additional Informationor 1+ year(s) of comparable experience (such as a clinical liaison, clinical navigator)

License / Certification Requirements

Registered Nurse LicenseBCLS or ACLS Certification

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