Summary

Continuously evaluates the quality, care, treatment and outcomes of assigned patient populations. Coordinates, verifies, negotiates alternatives, and case manages the care of complex patients to facilitate safe, high quality, cost effective care. Works collaboratively with the health care team to remove barriers and achieve the desired outcomes for patient/families. Collaborates with the patient/family and caregivers to facilitate necessary resources and options for placement to support a safe and efficient discharge.

Education

Bachelor of Science in Nursing (BSN) required.

Licensure/Certification

Must be an RN with current licensure.

Experience

Preferred recent experience in acute care setting. Preferred experience in Case Management activities. Preferred experience or knowledge of InterQual criteria.

Other Qualifications

Demonstrates knowledge of DRGs managed care initiatives, payment methods, and statistical analysis. Demonstrates understanding of managed care concepts. Must have good verbal and written communication skills. Must have excellent people skills and the ability to problem solve efficiently and effectively. Must be available to work flexible hours, assuming on-call duties on weekends and other times when deemed necessary. Must be available to respond within a reasonable length of time.