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      Urgent! RN-Hospital Case Manager, Full-Time, Days Position in Pineridge SC - Prisma Health
 
                        
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Job Summary The Hospital Case Manager (HCM) provides case management service for hospital patients, including, but not limited to, utilization management to ensure efficient, cost-effective patient progression through the continuum of care and discharge to an appropriate level of care.
In collaboration with physicians, leads the multidisciplinary team including clinical staff and payors to ensure efficient delivery of quality, cost-effective care.
Accountabilities Participates in discharge planning activities for patients with complex medical issues, in order to ensure a timely discharge and to provide appropriate linkage with post-acute care providers.
Accountable for appropriate levels of care and length of stay focus - 10% Consults with interdisciplinary team, Physician Advisor and administrative leadership as necessary to resolve barriers regarding progression of care.
Collaborates with physicians throughout hospitalization, develops an effective working relationship, and provides expertise regarding payor and regulatory guidelines.
- 10% Addresses and resolves system problems impeding diagnostic or treatment progress.
Proactively identifies and resolves delays and obstacles during the hospital discharge planning process.
Monitors the patient progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focuses, high quality, efficient, and cost effective.
- 10% On the basis of preliminary risk screening, assesses patients' and family's psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, reaction to illness and ability to cope.
- 10% Advocates for patient and family empowerment and independence to make autonomous health care decisions and access needed services within the health care system.
- 10% Maintains expert level knowledge of body systems and expected clinical outcomes for patient disease process.
Maintains current knowledge of changes in state and federal regulatory requirements related to the provision of case management services in a tertiary acute care setting.
Maintains case management knowledge to provide services in accordance with standards of practice as established by department and management.
- 10% Uses established clinical guidelines for initial/admission and continued stay reviews for patients within assigned unit to ensure medical necessity, appropriate level of care and timely implementation of plan of care in accordance with hospital(s) Utilization Review Plan.
- 10% Promotes effective and efficient utilization of clinical resources, ensuring quality, cost effective care.
Provides timely clinical reviews to third party payors.
Responds to requests for additional information within 24 hrs or next business day.
- 10% Ensures that patient goals are set with patient/family, negotiates healthcare resources and educates patient/family regarding options of care throughout the continuum.
Monitors patient's progress and intervenes as necessary to ensure delivery of quality, efficient, cost-effective services.
- 10% Serves as a resource for patients and families with regard to their rights and responsibilites, when payment of care is denied or when care is no longer medically necessary.
Includes, but not limited to, delivery of the regulatory documents as provided by CMS.
- 10% Minimum Qualifications Education - Bachelors degree in nursing Experience - Three (3) years acute care nursing experience.
One (1) year acute case management experience preferred.
Required Licensure - South Carolina RN license Other Required Skills/Experience N/A Work Shift Day (United States of America) Location Parkridge Facility 1560 Baptist Parkridge Hospital Department 15607517 Hospital Case Management Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve.
The transformation of healthcare requires talented individuals in every role here at Prisma Health.
                      
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Unlock Your RN Hospital Potential: Insight & Career Growth Guide
Real-time RN Hospital Jobs Trends in Pineridge, SC, United States (Graphical Representation)
Explore profound insights with Expertini's real-time, in-depth analysis, showcased through the graph below. This graph displays the job market trends for RN Hospital in Pineridge, SC, United States using a bar chart to represent the number of jobs available and a trend line to illustrate the trend over time. Specifically, the graph shows 426270 jobs in United States and 6902 jobs in Pineridge, SC. This comprehensive analysis highlights market share and opportunities for professionals in RN Hospital roles. These dynamic trends provide a better understanding of the job market landscape in these regions.
Great news! Prisma Health is currently hiring and seeking a RN Hospital Case Manager, Full Time, Days to join their team. Feel free to download the job details.
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An organization's rules and standards set how people should be treated in the office and how different situations should be handled. The work culture at Prisma Health adheres to the cultural norms as outlined by Expertini.
The fundamental ethical values are:The average salary range for a RN Hospital Case Manager, Full Time, Days Jobs United States varies, but the pay scale is rated "Standard" in Pineridge SC. Salary levels may vary depending on your industry, experience, and skills. It's essential to research and negotiate effectively. We advise reading the full job specification before proceeding with the application to understand the salary package.
Key qualifications for RN Hospital Case Manager, Full Time, Days typically include Other General and a list of qualifications and expertise as mentioned in the job specification. Be sure to check the specific job listing for detailed requirements and qualifications.
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Before the Interview:To prepare for your RN Hospital Case Manager, Full Time, Days interview at Prisma Health, research the company, understand the job requirements, and practice common interview questions.
Highlight your leadership skills, achievements, and strategic thinking abilities. Be prepared to discuss your experience with HR, including your approach to meeting targets as a team player. Additionally, review the Prisma Health's products or services and be prepared to discuss how you can contribute to their success.
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