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RN Case Manager I

Job Description
Works with multi-disciplinary team on implementing and evaluating patient care plans and progression throughout the continuum. Works collaboratively in communication with physicians, nursing and other members of the multi-disciplinary care team to effect timely and appropriate patient management. Uses utilization management techniques to determine the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities. Responsible for timely regulatory compliance and facilitation of precertification and payor authorization processes, when indicated. Actively participates in clinical performance improvement activities. Provides discharge planning and continuity of care for assigned patients in the acute and post-acute setting. Understands pre-acute and post-acute resources. Provides coordination of services and acts as key liaison between patient, the patient's family and the interdisciplinary healthcare members.
Requirements:
1- 2 years in clinical care or clinical case management.
BSN Required.
MSN Preferred.
Current RN license in VA.
CPR Certification Required.
ACM Certification Preferred.
Working knowledge of case management processes, needs assessment, principles of utilization review/quality assurance, discharge planning, and reimbursement structures (i.e. Medicare, Medicaid, HMO).
Knowledge of regulatory requirements.
Requirements
1- 2 years in clinical care or clinical case management.
BSN Required.
MSN Preferred.
Current RN license in VA.
CPR Certification Required.
ACM Certification Preferred.
Working knowledge of case management processes, needs assessment, principles of utilization review/quality assurance, discharge planning, and reimbursement structures (i.e. Medicare, Medicaid, HMO).
Knowledge of regulatory requirements.
Advanced communication (oral and written) skills to effectively and professionally liaison with patients, families, and medical staff.


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