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RN Case Manager - Emergency Room

Company: Renown Healthcare
Location: Reno
Posted on: June 13, 2019

Job Description:

Position Purpose

A clinical position that works within a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate appropriate level of care (which may or may not include hospitalization), ensure optimum utilization of resources to promote cost-effectiveness, safe discharge planning, and the overall improvement of patient satisfaction in a timely manner. The Case Manager is responsible for Utilization Review of the medical record to ensure care and services are delivered timely and appropriately. This positions is responsible to reduce and/or eliminate avoidable admissions.

Nature and Scope

The Case Manager has the responsibility to promote case management activities through the health continuum, beginning in the acute setting. Case management begins with the assessment of pre-morbid health status, current medical condition and post-acute needs. Emergency Room RN Case Managers have a unique role in that not all patients who enter the ER meet inpatient criteria for admission, but may require additional services for a discharge. Utilizing an interdisciplinary team approach, the Case Manager acts as a consultant and educator on matters referring to alternative levels of care and managed care issues,. In collaboration, Case Managers provide optimal patient care through, assessment, planning, implementation, and evaluation of neonatal, pediatric, adolescent, adult, and geriatric patients and families.

Specifics of Positions:
* Excellent documentation and communication skills and must be able to use critical thinking, find solutions quickly and be comfortable escalating when services or care are not delivered efficiently or appropriately.
* Attending rounds, review charts and ensure (when appropriate): * All orders written
* DC plan is in place and in computer
* Social Workers are assigned to appropriate patients
* Face to Face documentation is done and Choice forms obtained (When needed) are signed prior to DC
* Clinically Complex Cases are worked up appropriately for DC needs (wound vac, IV meds, Meds Requiring Pre Approval etc.)

* The Case Manager must respect beliefs and values while advocating for the client's right to self-determination and to make informed choices.
* The Case Manager documents all chart and phone reviews, identifies and communicates potentially avoidable/non-reimbursed days, quality indicators (such as re-admissions) and core measures.
* The Case Manager acquires and maintains knowledge and competencies related to the expectations of their position including an extensive knowledge of post-acute admission criteria (Rehab, LTAC and SNF etc.). Practice is aligned with the mission, vision and goals of the Integrated Health System. She/he participates in Quality Improvement initiatives.

This position does not provide patient care.


The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Minimum Qualifications Requirements - Required and/or Preferred:

Education: Must have working-level knowledge of the English language, including reading, writing and speaking English. Appropriate education to obtain and maintain State of Nevada Registered Nurse licensure. Bachelor of Science in Nursing preferred.

Experience: One year experience preferred as an RN. Case Management, Post-Acute experience and/or UR/QA experience preferred.

License(s): Ability to obtain and maintain a State of Nevada Registered Nurse license

Certification(s): National Certification (i.e. Case Management (CCM), Professional Utilization Reviewer (CPUR), or Managed Care (NMCC)) preferred. Current BLS/CPR certification required.

Computer / Typing: Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

Keywords: Renown Healthcare, Reno , RN Case Manager - Emergency Room, Executive , Reno, Nevada

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