RN- Case Manager w Utilization Review Experience
RN- Case Manager w Utilization Review Experience
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Job Description
Position Summary: The Registered Nurse NonCertified Case Manager works with physicians and multidisciplinary team members to develop a plan of care for assigned patients. Ensures patient is progressing towards desired outcomes by monitoring care through assessments and/or patient records. Identifies and resolves barriers that hinder effective patient care. Actively involved in discharge planning process. Minimum Qualifications: Required Montana Licensure (Registered Nurse) American Heart Association BLS Minimum of 2 years of nursing experience MUST HAVE UTILIZATION REVIEW EXPERIENCE Preferred Bachelor s Degree in Nursing 2 years of acute care hospital experience as a case manager Essential Job Functions: In addition to the essential functions of the job listed below employees must have ontime completion of all required education as assigned per DNV requirements Bozeman Health policy and other registry requirements. Completes comprehensive assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment changes in members health or psychosocial wellness and triggers identified in the assessment. Develops and implements a case management plan in collaboration with the member caregiver physician and/or other appropriate healthcare professionals and members support network to address the member needs and goals. Performs ongoing monitoring of the care plan to evaluate effectiveness document interventions and goal achievement and suggest changes accordingly. Maintains ongoing member case load for regular outreach and management. Promotes integration of services for members including behavioral health care and long term services and supports/home and community to enhance the continuity of care for members. Knowledge Skills and Abilities Demonstrates sound judgement patience and maintains a professional demeanor at all times Ability to work in a busy and stressful environment Strong interpersonal verbal and written communication skills Exercises tact discretion sensitivity and maintains confidentiality Computer applications MS Office EMR internet applications and standard office equipment Ability to analyze organize and prioritize work while meeting multiple deadlines Strong emotional intelligence interpersonal and teamwork skills Schedule Requirements This role requires regular and sustained attendance. The position may necessitate working beyond a standard 40hour workweek including weekends and afterhours shifts. Oncall work may be required to respond promptly to organizational patient or employee needs. Physical Requirements Lifting (Repeatedly 50 pounds): Exerting force occasionally and/or using a negligible amount of force to lift carry push pull or otherwise move objects or people. Sit (Occasionally): Maintaining a sitting posture for extended periods may include adjusting body position to prevent discomfort or strain. Stand (Repeatedly): Maintaining a standing posture for extended periods may include adjusting body position to prevent discomfort or strain. Walk (Repeatedly): Walking and moving around within the work area requires good balance and coordination. Climb (Rarely): Ascending or descending ladders stairs scaffolding ramps poles and the like using feet and legs; may also use hands and arms. Twist/Bend/Stoop/Kneel (Repeatedly): Twisting bending and stooping require flexibility and a wide range of motion in the spine and joints. Reach Above Shoulder Level (Repeatedly): Lifting carrying pushing or pulling objects as necessary above the shoulder requiring strength and stability. Push/Pull (Repeatedly): Using the upper extremities to press or exert force against something with steady force to thrust forward downward or outward. FineFinger Movements (Continuously): Picking pinching typing or otherwise working primarily with fingers rather than using the whole hand as in handling. Vision (Continuously): Close visual acuity to prepare and analyze data and figures and to read computer screens printed materials and handwritten materials. Cognitive Skills (Continuously): Learn new tasks remember processes maintain focus complete tasks independently and make timely decisions in the context of a workflow. Exposures (Continuously): Bloodborne pathogens such as blood bodily fluids or tissues. Radiation in settings where medical imaging procedures are performed. Various chemicals and medications are used in healthcare settings. Job tasks may involve handling cleaning products disinfectants and other substances. Infectious diseases are caused by contact with patients in areas that may have contagious illnesses. Emotionally challenging situations such as dealing with distressed patients or difficult family interactions.
Shift: Day Shift. 730am 430pm Weekend Rotations
Specialty Type: Nursing
Sub Specialties: Care Manager Medsurg Adult
General Certifications: N/APlease CLICK HERE to view details.
Employment Type
Full Time
