Case Manager RN – NH #1818
** This is a very hot position with high motivation to fill. They absolutely must have a current CCM certification.
Search For: RN, Case Manager, Case Management.
Position Title Case Manager RN – NH #1818
Location Salem NH
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.
1. RN Degree or Diploma.
2. Current RN licensure.
3. 3+ years medical, surgical clinical experience.
4. 3+ years case management or disease management experience.
5. Case Management certification, CCM.