Case Manager RN

Industry: Healthcare

Location: New Hampshire

Town / City: Salem

Job Type: Permanent full-time

Job description:

Job Summary:

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

resources.

* 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

personnel.

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

claims processing.

* 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

industry.

Bottom Line Requirements:

1. RN Degree or Diploma.

2. Current RN licensure.

3. Case Management certification, CCM.

4. Local or within the Region.