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RN Case Manager PRN

Job ID: 2105007581 Date posted: 07/14/2021 Facility: East Cooper Medical Center
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We know it takes a special person to be a nurse, and we are committed to providing our nurses with an enriching and rewarding environment. We provide the resources, tools and support our employees need to serve our patients and customers in the best way possible — so we can provide the right care, in the right place, at the right time, and do so with compassion.

  • Days
  • No travel

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Success Profile

What makes a successful Nurse at our location?
Check out the top traits we’re looking for and see if you have the right mix.

  • Innovative
  • Collaborative
  • Resourceful
  • Advocate
  • Person-centered
  • Critical thinker

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I feel like I'm rewarded in many ways. Just the time that I get to share with patients and learn who they are - I feel like that's a gift to me.”

- Elizabeth Vernon, RN

Benefits

  • Medical
  • Paid Time Off
  • Dental
  • 401(k)
  • Tutition
    Reimbursment
  • Life and
    Disability
    Insurance

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Responsibilities

The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case management scope of services including:

  • Utilization Management supporting medical necessity and denial prevention
  • Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction
  • Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care
  • Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy
  • Education provided to physicians, patients, families and caregivers

The individual’s responsibilities include the following activities: a) accurate medical necessity screening and submission for Physician Advisor review, b) care coordination, c) transition planning assessment and reassessment, d) implementation or oversight of implementation of the transition plan, e) leading and facilitating multi-disciplinary patient care conferences, f) managing concurrent disputes, g) making appropriate referrals to other departments, h ) identifying and referring complex patients to Social Work Services, i) communicating with patients and families about the plan of care, j) collaborating with physicians, office staff and ancillary departments, k) leading and facilitating Complex Case Review, l) assuring patient education is completed to support post-acute needs , m) timely complete and concise documentation in Case Management system, n ) maintenance of accurate patient demographic and insurance information, o) identification and documentation of potentially avoidable days, p) identification and reporting over and underutilization, q) and other duties as assigned.



Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Other Qualifications
1. Current license as a Registered Nurse in the State of South Carolina.
2. BSN or MSN preferred.
3. Minimum of three (3) years of hospital-based clinical experience preferred.
4. Previous Case Management, Utilization Review or Discharge Planning experience desirable.
5. Requires effective communication with patients, families, nursing, medical staff, and ancillary departments.
6. Ability to take initiative to resolve problems immediately and implement change in a timely basis.
7. Must be self-directed and able to adapt to change.

#LI-CG2

Job: Case Management/Home Health
Primary Location: Mount Pleasant, South Carolina
Facility: East Cooper Medical Center
Job Type: PT2Y
Shift Type: Days
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