RenoRecruiter Since 2001
the smart solution for Reno jobs

RN Case Manager

Company: Renown Health
Location: Reno
Posted on: June 14, 2019

Job Description:

Position Purpose

A clinical position that works within a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options of care, services and alternative levels of care to meet an individuals needs and facilitate appropriate discharge and length of stay. By assuming a leadership role with the interdisciplinary team, the Case Manager promotes appropriate utilization of care and services, and cost effective outcomes. 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 days.

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. The Case Manager works closely with the Bed Day RN who performs admission and concurrent continued stay reviews, together they ensure that services are being delivered at the most appropriate level of care to meet the clients needs and to secure reimbursement from payers.

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, to provide optimal patient care through, assessment, planning, implementation, and evaluation of neonatal, pediatric, adolescent, adult, and geriatric patients and families. This position also provides information such as certified LOS and reimbursement issues to physicians as needed to ensure the appropriate and timely disposition of the client to the next level of care. The Case Manager monitors and documents the progress of the plan, making revisions as needed, to assure a smooth transition to the next level of care at the time of discharge.

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 and ensure:


    • All orders written
    • DC plan is in place and in computer
    • Social Workers are assigned to appropriate patients
    • Choice forms (When needed) and IMMs are signed 48 hours prior to DC
    • All are in agreement with DC plan, date of DC and plan for care transitions
    • Review charts and ensure
    • All orders are written and signed and follow up with physicians (Hospitalist, UNR, Surgeons)
    • Face to Face documentation is done
    • DC summaries are written and in system in time for DC
    • Ensure all tests are scheduled timely and escalate as needed
    • Lab
    • Imaging
    • Surgery
    • LOS does not extend beyond what Bed Day Management review states is appropriate and ensures everyone on care team is working to DC timely 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 clients 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. As indicated, delivers non-coverage letters as set forth by payer and/or regulatory compliance.
    • 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.

      Disclaimer

      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 Health, Reno , RN Case Manager, Executive , Reno, Nevada

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Executive Jobs


Support Account Manager
Description: Coupa Software NASDAQ: COUP , a leader in business spend management BSM , has been certified as a Great Place to Work by the Great Place to Work organization. We deliver Value as a Service by helping (more...)
Company: Coupa Software
Location: Reno
Posted on: 06/17/2019

Management Trainee
Description: Atlantis Casino Resort Spa has built a reputation of excellence, and we remain focused on delivering the highest-quality experience in the industry. The caliber of service, attention to detail, and consistent (more...)
Company: Atlantis Casino
Location: Reno
Posted on: 06/14/2019

Salon Manager-Ridgeview Plaza - Store 1166- Ulta Beauty
Description: Salon Manager-Ridgeview Plaza - Store 1166- Ulta Beauty Responsible for meeting or exceeding salon service and pro-hair sales budget through staff recruiting and productivity development salon service (more...)
Company: Ulta Beauty
Location: Reno
Posted on: 06/14/2019


Commercial Lines Account Manager
Description: Commercial Lines Account Manager is a work from home position and who is a self-starter, well
Company: Patra Corp
Location: Reno
Posted on: 06/17/2019

Commercial Lines Account Manager
Description: Commercial Lines Account Manager is a work from home position and who is a self-starter, well
Company: Patra Corp
Location: Reno
Posted on: 06/16/2019

Salon Manager
Description: Salon Manager Responsible for meeting or exceeding salon service and pro-hair sales budget through staff recruiting and productivity development salon service promotions and salon service demonstrations. (more...)
Company: Ulta Beauty
Location: Reno
Posted on: 06/17/2019

Salon Manager
Description: Responsible for meeting or exceeding salon service and pro-hair sales budget through staff recruiting and productivity development salon service promotions and salon service demonstrations. Responsible (more...)
Company: Ulta Beauty
Location: Reno
Posted on: 06/17/2019

Distribution Center Department Manager - eCommerce
Description: Our vision at Petco is Healthier Pets. Happier
Company: Petco
Location: Reno
Posted on: 06/17/2019

Vans FT Assistant Store Manager (Legends 267 Sparks, NV)
Description: Job Description Vans: Be a Part of the Original It was never about waving the brand like a flag, it was always about the people Paul Van Doren Vans is the original action sports footwear company rooted (more...)
Company: VF Corporation
Location: Sparks
Posted on: 06/17/2019

RN Case Manager
Description: Position Purpose br br A clinical position that works within a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options of care, services and alternative levels (more...)
Company: Renown Health
Location: Reno
Posted on: 06/14/2019

Log In or Create An Account

Get the latest Nevada jobs by following @recnetNV on Twitter!

Reno RSS job feeds