JOB TITLE ………………………………. CASE MANAGEMENT-RN (203)
DEPARTMENT…………….. CASE MANAGEMENT/SOCIAL SERVICES
JOB CLASSIFICATION……………..EXEMPT
RELATIONSHIPS
Reports to ………………………….. MANAGER, CASE MANAGEMENT/SOCIAL SERVICES
Works with ………………………… ALL NURSING AND ANCILLARY DEPARTMENTS
…………………………. EXTERNAL AGENCIES AND VENDORS
POSITION SUMMARY
Under general supervision is responsible for assisting in carrying out the hospital’s Case
Management Plan. Educates staff regarding effective allocation of the hospital’s resources while
encouraging provision of high quality patient care. Is cognizant of regulations and policies of all review
organizations relating to billing of the fiscal intermediaries coordinates, monitors and evaluates options
and services to meet an individual’s health needs. Provides a full range of case management services
in collaboration, and communication with other staff members. Assesses, plans, implements,
coordinates, monitors, and evaluates options to facilitate the continuum of care.
ESSENTIAL DUTIES
Manage in a case management system using ongoing interaction with patients, physicians, and
other health providers to meet designated clinical, operational, and financial outcomes for aggregate
patient populations.
Assist physicians, patients, families, staff and payors in providing care for patient populations that is
appropriate, effective, and cost efficient.
Attend and actively participate in all departmental and interdepartmental meeting relative to Case
Management/ Social functions.
Collaborates with payors and review organizations to ensure proper utilization of patient care
resources.
Documents clearly and concisely all contacts and information of the patient’s case management
process on the appropriate chart forms.
Educates physicians and staff regarding appropriate level of care/utilization issues.
EDUCATION
Graduate of an accredited School of Nursing required.
PROFESSIONAL RESPONSIBILITIES
Maintains currant knowledge of Case Management/Social Services, discharge planning, and
nursing issues through continuing education.
Suggests and introduces new methods and techniques.
Participates in professional activities in order to continue their professional development and
contribute to that of the profession.
QUALIFICATIONS
*License/Certification
Current RN license required.
Current BCLS required. due at time of hire.
*Proof of all required License(s) and Certifications(s)
EDUCATION
** Proof of all required educational levels due at time of hire
REQUIREMENTS
Professional Certification in accordance with Case Management requirements.
Bi-lingual English/Spanish preferred
EXPERIENCE
Minimum of five (5) years acute hospital nursing experience and three (3) to five (5) years acute
hospital Case Management experience required.
SKILLS
Ability to work with diverse patient and staff populations with knowledge and sensitivity to cultural and
spiritual influences impacting on patient care
Exhibit a positive attitude
Ability to document Case Management plans in a clear and concise manner
Knowledge of state and federal programs that provide medical care and financial support to individuals
and community resources.
Ability to work independently, with little direction
Knowledge of the Continuum of Care and Utilization processes
Perform other job related duties as assigned by the Manager of Case Management/Social Services
