Location: New Hampshire
Town / City: Salem
Job Type: Permanent full-time
Through early intervention, the Case Manager will apply the six essential
activities of Case Management to assure achievement of an individual's
maximum level of wellness. Via appropriate, quality, cost-effective
alternative care delivery, the Case Manager will explore community resources
and alternative funding in order to maximize health care benefit. The Case
Manager will assist an individual to self-direct and self-advocate thus
assurance of an informed and empowered healthcare consumer.
Essential Duties and Responsibilities:
* Acts as an advocate and approaches clientele, according to
his/her level of wellness, handicap, or injury with alternatives which may
improve his/her quality of life.
* Ethically engages in the six essential activities of the Case
Management process in order to assess, plan, implement, coordinate, monitor
and evaluate health care delivery.
* Applies six components of case management to each of the five
core areas: coordination/service delivery, physical/psychological factors,
benefit systems and cost analysis, case management concepts and community
* Practices case management within the full continuum of care
encompassing multiple environments.
* Interacts with all healthcare systems and continues involvement
with all participants to deal with an individual's broad spectrum of need.
* Applies CMSA standards of practice to an individual's holistic,
healthcare, occupational, psychosocial, cultural and financial need.
* Composes confidential, timely, report mechanisms that clearly
document goals, objectives, outcomes and cost benefit analysis.
* Acts as a resource to Utilization Review, Behavioral Health,
Disability and Case Management team members, committees, clientele and
Education and/or Experience:
* RN Degree or Diploma :current NH/PA license, RN licensure
within state of case management practice
* 3 years medical, surgical clinical experience: 3-5 years case
management or disease management experience. Case Management certification
Knowledge and skills:
* Excellent written/oral/communication skills.
* Intermediate Word, Excel computer skills.
* Demonstrated success as a case manager with basic Utilization
Review skills, Managed Care Software knowledge.
* Knowledge of the insurance industry, benefits coverage and
* Ability to apply the six components to the five core areas of
the case management process.
* Knowledge of case management principals, clinical guidelines,
and CMSA standards.
* Ability to prioritize caseload, combining comprehensive nursing
knowledge and skill with cost savings methodology and technique.
* Knowledge of health care providers, alternative funding and
community resources; ability to prioritize and utilize them efficiently
within the benefit plan.
* In depth knowledge of nursing care plans/skill and ability to
facilitate and coordinate transition of patients with catastrophic
injuries/illnesses through cost effective, medically appropriate,
alternative levels of care.
* Actively serves on an committee.
* Participates in in-service/provider education.
* Maintains membership and activity in a professional affiliation,
i.e. Case Management Society of America, Case Management Society of New
England, ANA in order to promote professional development within the
Bottom Line Requirements:
1. RN Degree or Diploma.
2. Current RN licensure.
3. Case Management certification, CCM.
4. Local or within the Region.