The position provides comprehensive care coordination for patients as assigned and assesses the patients plan of care. The Case Manager is responsible for Length of Stay management and discharge planning. Develops, implements, monitors and documents the utilization of resources and progress of the patient through their care, advocating and facilitating options and services to meet the patients health care needs. Interacts extensively with the care teams to support the clinical roadmap. The intensity of care coordination provided is situational and appropriate based on patient need and payer requirements. This position works independently, receiving supervision of work activities from the Lead CM team, Supervisor of Case Management and Manager of Case Management and is accountable for the quality of clinical services delivered by both them and community partners and identifies/resolves barriers which may hinder effective patient care.
Education
Bachelors degree in Nursing or a combination of Associate degree in Nursing coupled with 3 years clinical experience. (Required)
Masters degree in Nursing (Preferred)
Experience
Minimum of (1) year of broad clinical experience. Care coordination, case management, discharge planning and utilization review experience preferred. (Required)
Working knowledge of the financial aspects of third party payers and reimbursement. (Preferred)
Working knowledge of the use of evidence-based guidelines to effectively manage length of stay. (Preferred)
Certifications
Current State of Arizona RN license (Required)
Case Management Certification (CCM) (Preferred)
Current BLS Certification for Health care Provider from the American Heart Association (Required)
Valid AZ Department of Public Safety (DPS) Fingerprint Clearance Card (Required)
Valid Compact State RN License (Required)
Special Skills
Bilingual (Spanish) (Preferred)
MCG criteria knowledge (Preferred)
Excellent communication skills, both verbal and written. (Required)
Effective critical thinking skills and ability to anticipate patient discharge needs. (Required)
Moderate to expert computer skills (Required)
Effective decision-making /problem-solving skills, demonstration of creativity in problem-solving, influential leadership skill. (Required)
