RN Case Manager

General Summary: Under general supervision and according to established procedures, collects pertinent information relating to the admission of patients to the hospital, their continued stay and the appropriate use of hospital resources and facilities. Reviews concurrently the information using guidelines developed and approved by the Utilization Review Committee. Acts as liaison with insurance and third party payer for review. Age specific and using principles specific to pediatrics, adolescents, adult and elderly patients. Qualifications: 1. Mustbe RN or LPN, licensed in Illinois, BSN or MSN preferred 2. Must be knowledgeable and supportive of all aspects of the utilization review program 3. Min 3 years experience working with patients in a clinical setting 4. Must possess strong oral and written communication skills 5. Must possess analytical ability in order to objectively collect and evaluate data to define trends in patterns of utilization 6.Should demonstrate a high degree of clinical nursing skills with the ability to make objective professional judgements Integrate nursing case management with social work case management Identifying patient/family care needs Handle case intake and daily case management Provide telephonic medical case management strategy Serving in a case/care manager role Designated as the case manager for hospice patients Apply effective case management interventions Perform initial case management assessment to determine care coordination and discharge planning needs Evaluate outcomes of patient care Assuming nursing case management responsibilities for designated patients Identify members for case management Provide case management services to geriatrics patients Assume responsibility to coordinate patient care for assigned case load Manage the patient case from pre-admission through discharge Facilitating appropriate health care services throughout the continuum of care Identifying appropriate patients for care management Coordinate the overall interdisciplinary care plans for home health/hospice patients from admission to discharge Evaluate outcomes of care with the interdisciplinary team and medical case managers Providing patient case management services to assigned populations Performing ongoing telephonic case management and treatment planning