Case Manager

Employment Type:Full timeShift:Day Shift

Description:The RN Case Manager (RN CM), works in collaboration with a multidisciplinary team by identifying and initiating discharge planning to accomplish the timely transition of patients to a post-acute hospital setting and to ensure patients progress along the continuum of care. RN CM facilitates patient transitions efficiently and in a cost-effective manner that ensures quality outcomes. RN CM utilizes established guidelines to support appropriate level of care throughout hospitalization in compliance with CMS and organizational utilization management requirements. RN CM helps to ensure medical necessity is met by regularly reviewing severity of illness and intensity of service for patients to ensure appropriate and timely utilization of hospital services.

Essential Functions and Responsibilities

Uses approved criteria for admission and continued stay reviews to ensure appropriate setting and timely implementation of plan of care. Collaborates with admitting and/or attending physicians regarding appropriate level of care/status determination. Consults with Physician Advisor and administrative leadership as necessary for those patients not meeting medical necessary services for acute care. Effectively organizes and sets priorities on assignment caseload. Knowledgeable of Medicare, Medicaid and non-governmental payer regulations for patient care requirements. Completes biopsychosocial assessment of patients to determine post-acute needs. Implements safe discharge/treatment plans in a timely manner to prevent avoidable inpatient stays. Serves as a resource to the healthcare team.   Evaluates hospitalized patients to ensure they are receiving services in the most appropriate and cost-effective level of care in collaboration with attending physicians and Physician Advisors. Helps to identify problems, offer solutions, and participates in their resolution.

Our Commitment to Diversity and Inclusion
 

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.