What is the role of a RN Care Mgr UR Case Mgmt at Carteret Health Care?

The RN Care Mgr UR Case Mgmt position at Carteret Health Care is a Full-time or part-time position opportunity in the relevant field.

Where is this RN Care Mgr UR Case Mgmt job located?

Morehead City, North Carolina, 28557, United States

What type of employment is offered for this RN Care Mgr UR Case Mgmt role?

Full-time or part-time position

What industry does this RN Care Mgr UR Case Mgmt position belong to?

This role spans multiple industries.

What is the expected salary for this RN Care Mgr UR Case Mgmt job?

Compensation will be discussed during the hiring process.

How can I apply for the RN Care Mgr UR Case Mgmt position at Carteret Health Care?

You can apply directly through the application link provided.

RN Care Mgr UR Case Mgmt at Carteret Health Care

RN Care Mgr UR Case Mgmt

JOB RELATIONSHIPS
- Reports to the Director of Research and Innovation in collaboration with the CNO/VP of Patient Care
  Services
DEFINITION OF POSITION
- The Registered Nurse (RN) Care Manager will:
  - Conduct a comprehensive assessment and develop thoughtful plans to implement, coordinate, monitor,
    and evaluate healthcare services tailored to meet each individual’s specific needs in a cost-effective
    manner.
  - Perform utilization reviews to assess the appropriateness and medical necessity of healthcare services
    for patients, while fostering strong relationships with payers to ensure compliance and alignment.
  - Foster strong relationships with payers to ensure compliance and alignment
  - Act as a patient advocate to guide patients through the complex healthcare system, ensuring their
    preferences and rights are respected and helping them access appropriate care or coverage
  - Facilitate coordinated patient care by collaborating with patients, their families, healthcare staff,
    physicians, Advanced Practice Provider (APPs) and community services, all aimed at promoting quality
    care.
  - Incorporate cultural competence and awareness of Social Determinants of Health (SDOH) into assessment
    and care plan development to ensure a holistic approach to patient well-being
  - Take the lead on discharge planning and care coordination initiatives, with the goal of minimizing
    readmissions.
  - Work closely with interdisciplinary teams to create and refine patient-centered care plans.
  - Regularly monitor key performance indicators (KPIs), such as length of stay and readmission rates, to
    ensure optimal service delivery.
  - Uphold stringent adherence to guidelines established by CMS, the Joint Commission, and all relevant
    payer requirements.
QUALIFICATIONS
- Professional
  - Registered nurse with current North Carolina license (BSN preferred).
  - Current BLS Healthcare Provider certification.
  - Three years clinical experience in a health care facility with knowledge base of clinical nursing principles
  - Case Management Certification (CCM), Accredited Case Manager (ACM) and/or Health Care Quality and Management (HCQM) certification preferred
  - Knowledge of current trends and issues related to utilization and case management principles related to the hospital practice setting.
  - Computer experience
  - Evidence of participation in ongoing continuing education programs.

RN Care Mgr UR Case Mgmt at Carteret Health Care – Morehead City, North Carolina

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