The Case Manager is responsible for coordinating patient care activities to conform to evidence-based practice and/or regulatory/payor requirements.
The individual’s responsibilities will include, but not be limited to the following activities: a) medical necessity screening b) care coordination c) discharge planning d) facilitating multi-disciplinary patient care conferences e) managing concurrent disputes f) making the appropriate referrals to other departments (e.g., nutrition, PT/OT/ST) g) referring complex social issues to Social Service h ) communicating with patients and their families about plan of care i) collaborating with physicians, office staff and ancillary departments (e.g., lab, pharmacy) j) participating in weekly Complex Case Review k) arranging for post –discharge patient education l) clear, complete and concise documentation in eCCM m) maintaining accuracy of patient demographic and insurance information n) identifying and documenting potentially avoidable days o) identifying and reporting over and under utilization.
Required qualifications should include a) R.N. (minimum of B.S.N. preferred) with at least 3 to 5 year’s experience in the relevant clinical specialty (e.g., case manager for pediatrics patients should have pediatric nursing experience) b) excellent organizational skills c) excellent verbal and written communication skills; d) ability to lead and coordinate activities of a diverse group of people; e) demonstrated critical thinking and problem solving skills; and g) computer literate
Case Managers hired prior to August 2009 are grandfathered in with the same performance expectations.
Minimum Licensure and Certification:
A valid Permanent Multi-State RN License from the state in which you reside is required. Should you hold a RN license from another Compact state, you are required to apply for and obtain a Multi-State RN
License from the state in which you reside within 30 days. BSN preferred. BLS Required.
Minimum Experience/Additional Certification: 3 – 5 years RN clinical experience. Case Management experience preferred.
Rock Hill, South Carolina
Piedmont Medical Center
8 Hour Day
If Other Shift, Specify:
32 HOURS PER PAY PERIOD