The Case Management RN facilitates effective utilization of appropriate health services via collaboration with physicians, nurses, social workers, other health care team members, and payors to coordinate health care services that optimize clinical outcomes and patient satisfaction from admission through post-discharge transition. The RN Case Manager is responsible for ensuring implementation and monitoring of compliant documentation strategies by ensuring orders are present, accurate, and signed prior to patient being discharged. Under the guidance of the Director of Case Management, the RN Case Manager is responsible for clinical reviews, transition of care, patient outcomes, and patient education.
MINIMUM QUALIFICATIONS AND REQUIREMENTS
Licenses and Certifications Required
Current or temporary RN license in ND or compact RN licensure required
BLS certification preferred
Educational Requirements
BSN preferred
Experience Requirements
Must have three (3) years of recent experience in a clinical area
Prior Case Management/Utilization Review experience preferred
Special Skills or Training Requirements
Demonstrated evidence of dependability, diplomacy, and initiative
Demonstrated strong communication and interpersonal skills with all levels of internal and external customers, including but not limited to medical staff, patients and families, clinical personnel, other Case Managers, support and technical staff, outside agencies, third party payors, and members of the community
Basic understanding of reimbursement issues, denials, and DRGs
Knowledge of clinical criteria for medical necessity
Personal computer skills using e-mail, word processing, etc.
