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Job Title:

Case Manager-RN

Cost Center:

Behavioral Health Services

Job Description:

The Clinical Case Manager RN proactively consults with the interdisciplinary team which includes patient care staff, physicians, and patient support and family and community resources with physicians and the other members of the interdisciplinary team to ensure that patients are admitted and transitioned to the appropriate level of care, have an effective plan of care and are receiving prescribed treatment, and have an advocate for services and plans needed during and after their stay. They to assure a smooth transition for the patient through appropriate levels of care to facilitate quality outcomes. Minimum Qualifications
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Education
Graduate of an accredited school of nursing
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Credentials
Must possess a current, valid RN license in state of practice, temporary RN license in state of practice, or compact RN licensure for current state of practice.
GPH Required/Preferred: None
Work Environment
An office cubicle setting and works throughout clinical areas. Exposure to blood and body fluids, contagious diseases, medical gases, confined areas, constant use of the telephone, frequent use of the computer, and carries and uses laptop computer.
Physical Demands
Stand and/or walk frequently.
Sit frequently.
Bend, stoop, and crouch occasionally.
Reach floor to overhead occasionally.
Lift and/or carry 5 pounds 100 feet frequently.
Push and/or pull 5 pounds occasionally.
Visual acuity and hearing within normal limits.
Fine motor coordination within normal limits
Computer use frequently.

Essential Functions
Work closely with interdisciplinary care team to identify high-risk, complex patient cases; manage care, including referral management, care planning, post discharge planning and coordinating community-based and transitional care.
Conduct individualized clinical evaluations of patients, their health needs and concerns; develop personalized action plans, provide education ad issue referrals for case management programs, monitor patient’s progress in meeting established goals and modify care plans accordingly.
Develop a cohesive and strong team oriented relationship with physicians, nurses and other health care professionals; evaluate and report on patient health outcomes and work in partnership with interdisciplinary health care team to facilitate the best inpatient care.
Direct discharge planning process in support of treatment adherence and medication compliance; assist with transitions for patient’s discharged from an inpatient/observation stay to a facility or home to include coordinating services, including scheduling, transportation, and follow up.
Guide, intervene and advocate on behalf of patients, their caregivers, and or families in regards to navigating and comprehending the health care system; coordinate resources in the community to ease transition
Use effective relationship management, coordination of services, resource management, education, patient advocacy, and related interventions to: Promote, improved quality of care and/or life, cost effective medical outcomes, decreased lengths of hospitals stays when appropriate and continuity of care
Prevent complications and hospitalization/readmissions when possible and appropriate
Perform prospective, concurrent and retrospective utilization reviews per InterQual criteria and national guidelines.
Collaborates with the Physicians in managing the patient’s length of stay or transfer and determining the appropriate level of care for the next phase of the patient’s care.
• Ensures physician specific plan of care is being followed for all patients.
• Reviews clinical findings and diagnostic reports, correlates medical record findings with patient assessment findings.
• Ensures appropriate resource utilization relevant to the financial, regulatory and clinical aspects of care; proposes alternative treatment to ensure cost effective and efficient plan of care when appropriate.
The CCM works directly with the inpatient Social worker/resource planner to initiate the formation and administration of comprehensive patient plans for post-hospital care for patient.

Join us. Join great. Join the dynamic team at Great Plains Health and be a part of something truly exceptional. At Great Plains Health, we embody a culture defined by authenticity, integrity, and a genuine commitment to listening to both our patients and each other.

As a member of our team, you'll experience a supportive environment where collaboration is key, and every voice is valued. We work together seamlessly, leveraging our collective strengths to provide the highest quality care to our community.

Passion drives us forward, propelling us to constantly strive for excellence in everything we do. If you're seeking a rewarding career in healthcare surrounded by like-minded individuals who share your dedication and enthusiasm, Great Plains Health is the place for you. Come join us and be part of a team that's making a real difference every day.