Registered Nurse Case Manager Resume Samples

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C Jacobs

Cali

Jacobs

1400 Brandon Haven

San Francisco

+1 (555) 655 8734

1400 Brandon Haven

San Francisco

Phone

p +1 (555) 655 8734

Experience Experience

Boston, MA

Registered Nurse Case Manager

Boston, MA

Bogan-Connelly

Boston, MA

Registered Nurse Case Manager

Providing patient education to assist with self-management
Tracks and trends variances barriers related to access to care; makes recommendations and develops action plans to improve processes and systems
Providing patient education to assist with self-management of their medical condition or disease processes
Assists in managing performance improvement projects
Demonstrates initiatives in developing, implementing and analyzing quality improvement strategies for the case management department
Assist in the development of case management policies and procedures
This is a full time RN Case Manager position that works three 12 hour shifts per week and works every other weekend

Philadelphia, PA

Registered Nurse / Case Manager

Philadelphia, PA

Gulgowski, Kris and Sporer

Philadelphia, PA

Registered Nurse / Case Manager

Keeps abreast of all changes in policies and procedures relating to Utilization Management, Discharge Planning and Case Management process
Coordinates patient discharge with physician, managed care agency, social work services, patient and family
Performs Clinical Care Coordination assessment within 72 hours of admission on all patients. Perform ongoing reviews every 48 hours or as necessary
Makes referrals to other hospital departments for collaboration and assistance in discharge planning
Develops and documents a post discharge care plan in conjunction with other members of the health care team based on initial patient assessment
Identifies problematic care patterns or cases and make referrals to the Supervisor and the department involved
Assists in identifying patient incidents through the NYPORTS program

present

New York, NY

Registered Nurse Case Manager / Days

New York, NY

Gaylord, Casper and Zieme

present

New York, NY

Registered Nurse Case Manager / Days

present

Coordinates the integration of social services/case management functions into the patient care, discharge and home planning processes with other hospital departments, external service organizations, agencies and healthcare facilities
Collaborates with clinical staff in the development and execution of the plan of care and achievement of goals
Utilization Review, Quality and Compliance Monitoring
Conducts concurrent medical record review using specific quality indicators and clinical decision support criteria as approved by the medical staff, TJC, CMS and other regulatory agencies and document findings
Serves as liaison with Physician Performance Improvement (PPI) to ensure the reporting of quality indicators and care concerns
Reviews all new admissions daily against inpatient screening criteria and communicates necessary changes in status designation to ordering physician and Patient Access
Identifies all observation patients with observation alert sticker, reviews status no less frequently than daily, and communicates directly with the attending physician if severity of illness and intensity of service meet criteria for inpatient admission or when observation hours threaten to exceed 48 hrs

Education Education

Bachelor’s Degree in Case Management

The George Washington University

Bachelor’s Degree in Case Management

Skills Skills

RN / BSN
5+ years of acute care experience
Discharge planning, utilization management, home care experience
Supervisory experience
Positive attitude, self directed, pleasant, cooperative, assertive
Professional demeanor with patients, families, physicians, and fellow employees
Knowledge of nursing theory and principles and the sustained ability to remain calm, productive and focused under stress conditions
In-depth understanding of and skill in using nationally recognized medical utilization criteria sets,(ie InterQual)
Responsible for processing Medi-Cal TARS (Treatment Authorization Request) and obtaining physician signature in a timely manner
Collaborates with discharge coordinator regarding patient cases not meeting intensity of services/severity of illness criteria

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Registered Nurse Case Manager Resume Examples & Samples

RN / BSN
Discharge planning, utilization management, home care experience
Positive attitude, self directed, pleasant, cooperative, assertive
Professional demeanor with patients, families, physicians, and fellow employees
Knowledge of nursing theory and principles and the sustained ability to remain calm, productive and focused under stress conditions
In-depth understanding of and skill in using nationally recognized medical utilization criteria sets,(ie InterQual)

Registered Nurse Case Manager Patient & Family Services Per Diem Hours Days Resume Examples & Samples

Collaborates with discharge coordinator regarding patient cases not meeting intensity of services/severity of illness criteria
Initiates the appeal process upon notification of denial by business office
Demonstrates knowledge of pediatric, adolescent, adult and geriatric variations in treatment/procedure as evidenced by annual age specific competency assessment/evaluation

Registered Nurse Case Manager Resume Examples & Samples

Responsible for admissions, concurrent and/or retrospective reviews of all patients in accordance with the criteria and the policies and procedures approved by the Performance Improvement Committee, and consistent with Federal and State guidelines, PRO regulations, JCAHO standards and contractual agreements with insurers or outside review agencies
Serves as a liaison to
Responsible for processing Medi-Cal TARS (Treatment Authorization Request) and obtaining physician signature in a timely manner

Registered Nurse Case Manager Resume Examples & Samples

Possess knowledge of case management or utilization review as normally obtained through the completion of a bachelor's degree in case management or health care
Proficiency level typically achieved with 5 years clinical experience
Ability to work effectively in an interdisciplinary team format
Acts in a leadership function to collaboratively develop and manage the interdisciplinary patient discharge plan. Effectively communicates the plan across the continuum of care
May supervise other staff

Registered Nurse Case Manager Resume Examples & Samples

Knowledge of case management or utilization review as normally obtained through the completion of a bachelor's degree in case management or health care
Current Registered Nurse $R.N.$ license in Arizona
Basic Life Support $BLS$ certification, required

Registered Nurse Case Manager Resume Examples & Samples

Interacting with Medical Directors on challenging cases
Educating members on disease processes
Documenting and tracking findings
Making post-discharge calls to ensure that discharged member receive the necessary services and resources
A current, unrestricted RN license in the State of Georgia
3+ years of experience in a hospital setting, acute care, direct care experience OR experience as a telephonic Case Manager for an insurance company
1+ year of clinical experience dealing with adult patients
Multiple state licensure (in addition to Compact License if applicable) or ability to obtain multiple state nursing licenses
Case or disease management experience
Experience working with Medicare / geriatric patients
Experience / exposure with discharge planning
Certified Case Manager (CCM)
Bilingual (Spanish / English) skills
Medical / Surgical, Home Health, Diabetes or Cardiac experience or certification
Computer proficiency, to include strong data entry skills and the ability to navigate a Windows environment

Registered Nurse Case Manager PRN Resume Examples & Samples

RN with current state licensure, BSN preferred
Three years nursing experience in acute care setting with Case Management experience preferred
Knowledge of PRO, HCFA, HRS regulations

Registered Nurse Case Manager Resume Examples & Samples

Performs admission and continued stay reviews. Provides clinical information to payers upon request for certification and reimbursement of care. The RN Case Manager discusses alternate levels of care with physician. Refers cases not meeting acute care criteria to Physician Advisor as needed
The RN Case Manager is knowledgeable of all JCAHO, HCFA, and state/federal requirements for provision of care, planning, and documenting
Graduate of an accredited diploma, associates, or baccalaureate degree nursing program. (required)
Minimum of 3 years clinical experience in area in which Case Management was performed. (preferred)

Registered Nurse Case Manager PRN Resume Examples & Samples

Assesses discharge needs of all high-risk patients (and others referred). Identifies resources available to address the needs identified, coordinate referrals, and document plan
Utilize community resources to support patient’s post hospital needs. Documents choice in available resources
Facilitates and provides education of hospital staff, physicians, patients, and caregivers for purposes of efficient resource utilization
Tracks resource statistics to identify improvement opportunities. Reports findings at medical staff and other hospital committee meetings
At least one year experience in utilization review, resource management, discharge planning, or case management. (preferred)

Registered Nurse Case Manager Resume Examples & Samples

Coordinates the discharge planning process ensuring involvement of all members of the healthcare team. Counsels with patients and family members in decision making and in meeting psycho social needs of the patient
Compiles, evaluates, and reports statistics to members of the team and utilizes the information to facilitate process improvement activities
Minimum 2 years of clinical nursing experience

Registered Nurse Case Manager Resume Examples & Samples

Under the supervision of the Director of Continuum of Care Department the RN Case Manager provides oversight and intervention through assessing, planning, coordinating, monitoring and evaluation of services required to respond to individual patient needs
The case manager is responsible for utilization review, discharge planning and care coordination with the patient, patient’s family, physician and health care team
The case manager works with other members of Continuum of Care Department sharing responsibilities as assigned to meet the needs of each patient
Graduate from an accredited School of Nursing and or Bachelor of Science in Nursing Degree
Minimum of 3 years clinical nursing experience, preferably 1 year of experience in Managed Care
Ability to work both independently and collaboratively with other professionals
Able to assess patient care needs and utilize available resources to provide safe discharges

Registered Nurse Case Manager Resume Examples & Samples

Assesses, develops, implements , coordinates and monitors a comprehensive plan of care in collaboration with the physician and interdisciplinary team
Balances individual clinical and psychosocial patient/family needs with the efficient and cost effective utilization of resources, while promoting quality outcomes
This is a full time RN Case Manager position that works three 12 hour shifts per week and works every other weekend
Graduation from an accredited school of nursing. Bachelors’ degree preferred
Current RN license for the State of Missouri and Commissioned as a Notary Public for the State of Missouri within 18 months of hire

Registered Nurse Case Manager Resume Examples & Samples

Applies problem-solving techniques to the Case Manager process
Assesses variables that impact on health and functioning
Interprets clinical information and assess implication for treatment
Develops an individualized case management plan that addresses singular physical, vocational, psychosocial, financial and educational needs
Understands insurance policy language
Presents various health care options
Documents Case Management activities
Maintains familiarity with disease processes available resources and treatment modalities, assessing their quality and appropriateness for specific disabilities, illnesses and injuries
Adheres to and complies with HCA's ethics and compliance policies and procedures in the Code of Conduct. Attends annual training sessions
At least 1 year experience as a case manager in a healthcare setting preferred
Knowledge of accreditation and regulatory standards
Interpersonal skills in working with physicians, healthcare professionals, patients and families
Possess working knowledge of utilization review, case management and DRGs
Demonstrate knowledge of commercial insurance requirements/criteria for indications of hospitalization
Requires working in a fast-paced setting and self-motivated

Registered Nurse Case Manager / Days Resume Examples & Samples

Financial Assessment and Coordination
Communicates proactively and cooperatively with Patient Access, Patient Account Services (PAS) and Central Verification Office (CVO) personnel to ensure proper pre-certification and consistency of admissions status designation between physician order and EMR
Communicates known changes to patient payer information and other relevant financial characteristics of coverage to appropriate admissions and/or billing personnel
Proactively ensures that required clinical justification is provided to third party payers to obtain recertification for continued hospitalization and treatment and that transfer of this information, together with days approved and contact information is provided timely to the PAS and CVO via computerized insurance review documentation
Serves as liaison between third party payers, patient access PAS and CVO to ensure communication of all pertinent information regarding level of care, billing and reimbursement
Works with the patient and family to identify alternate financial resources available to meet the cost of necessary post-discharge needs or to recommend alternate care options when necessary funding is unavailable
Proactively initiates expedited appeals process with payers and communicates with denials management regarding anticipated or verified denials and cooperates with denials management to provide additional clinical information for appeals
Treatment Planning and Coordination of Services
Educates patient and family on case manager role and process for contacting the case manager for questions
Coordinates the integration of social services/case management functions into the patient care, discharge and home planning processes with other hospital departments, external service organizations, agencies and healthcare facilities
Ensures that patient tests are appropriate and necessary and are carried out within the established time frame and that results are promptly available
Serves as a patient advocate by enhancing a collaborative relationship to maximize the patient's and family's ability to make informed decisions
Utilization Review, Quality and Compliance Monitoring
Reviews all new admissions daily against inpatient screening criteria and communicates necessary changes in status designation to ordering physician and Patient Access
Identifies all observation patients with observation alert sticker, reviews status no less frequently than daily, and communicates directly with the attending physician if severity of illness and intensity of service meet criteria for inpatient admission or when observation hours threaten to exceed 48 hrs
Communicates with treating physicians at regular intervals throughout hospitalization of the patient to develop an effective working relationship, while assisting physicians to maintain appropriate costs, utilization of resources, and discharge plans commensurate with the patient's available resources
Monitors and provides documentation of identified variance days for tracking and trending
Stays current with education related to CMS and HCA billing compliance mandates, monitors and ensures that facility is compliant
Discharge Planning and Continuity of Care
Facilitates the ordering and delivery of specialized medical equipment, orthotics and prosthetics as ordered by the attending physician
Facilitates referral process of next level of care
General Duties
Actively utilizes and complies with facility principles of good communication and customer service standards, including use of AIDET as developed by the department
Prepares and presents inservice and training programs as requested
Ability to read, analyze and comprehend complex clinical and financial data and its application to level of care criteria and discharge options; strong, broad-based clinical knowledge and understanding of pathology/physiology of disease processes; excellent critical thinking skills; assertive personality traits to facilitate ongoing physician communication; organize, prioritize and manage time efficiently. Computer literacy and familiarity with the operation of basic office equipment. Must be able to communicate effectively with a wide range of hospital personnel, physicians, patients/family members within various socioeconomic groups and representatives of varied outside agencies. Ability to communicate effectively with and know the age-specific needs of patients of adolescent, adult and geriatric age

Registered Nurse Case Manager Resume Examples & Samples

The Care Coordinator promotes inter-professional synchronization throughout the acute episode, and completes effective handoff to the next level of care or community to ensure continuity of care
The Care Coordinator proactively assesses, identifies, and works to mitigate the risk posed by barriers to the patients’ transitions of care
The Care Coordinator works in partnership with the patient and/or care partner(s) to develop a comprehensive, individualized transitional care plan. Participation and leadership in patient rounding activities, huddles, and committee meetings is expected, where appropriate
The role requires the successful completion of annual competency training, as assigned. Care coordinators are required to obtain certification by an approved entity within one year of eligibility
Minimum of three years of recent RN clinical experience required. Minimum of two years of recent experience in Utilization Review, Quality, or Care Management preferred
Knowledge of acute care regulatory/accreditation requirements preferred. Discharge planning and/or Quality Improvement experience preferred

Registered Nurse Case Manager Resume Examples & Samples

Making outbound calls and taking inbound calls to assess members' current health status
Interacting with Medical Directors/Pharmacists on challenging cases
Coordinating care for members i.e. Partnering with internal and external vendors including, Behavioral Health, Wellness, Social Workers, EAP
Communication with customers and/or account management teams
Collaboration with Primary Care and Specialty Providers
Multiple state licensure (in addition to Compact License if applicable) or ability to obtain multiple state nursing licenses within 12 months

Registered Nurse Case Manager Resume Examples & Samples

Utah RN license required
Three to five years experience in an acute care setting. Two years experience in Case Management and/or Discharge Planning preferred
Excellent public relation skills, knowledge of community resources, knowledge of regulatory agencies

RN / Registered Nurse Case Manager Resume Examples & Samples

Typing 25 wpm
BLS (CPR)
Light Work - exert/lift up to 20 lbs. force occasionally, and/or up to 10 lbs. frequently

Registered Nurse Case Manager Per Request Needed Resume Examples & Samples

4 years of clinical experience as a Registered Nurse
Experience in Case Management, utilization review, nursing clinical quality or discharge planning preferred
RN-Colorado
Sedentary Work - prolonged periods of sitting and exert/lift up to 10 lbs. force occasionally
Important notification to applicants as of Nov. 20, 2014: Effective Jan. 1, 2015, Centura Health will no longer hire tobacco users in Colorado and Kansas. The change to our policy does not apply to associates hired on or before Dec. 31, 2014. Centura Health is an Equal Opportunity Employer, M/F/D/V

Registered Nurse Case Manager Resume Examples & Samples

Making outbound calls and service inbound calls to assess members' current health status
Identifying gaps or barriers in treatment plans and partner with member to develop an effective care plan
Providing patient education to assist with self-management of their medical condition or disease processes
Collaborate with Medical Directors on high clinical and financial risk cases
Collaborate with Pharmacist regarding medication reconciliation, including lower cost alternatives, medication interactions
Holistic multi-disciplinary coordination of care for members, including partnering with Inpatient Case Manager, Physicians, Ancillary providers, Social Workers and other internal and external clinical programs
Facilitating referrals to Health programs and additional approved resources to assist members in managing their health more effectively
Empower members to actively participate in their health care including healthy lifestyle changes
Proactively begin readmission prevention and discharging beginning with outreach to the member upon admission to the hospital and post-discharge to ensure the member has the appropriate services and resources in place for a successful recovery
Graduate of an Accredited RN program
Current, unrestricted RN license in the State of Illinois
3+ years recent clinical experience as an RN ( Acute care, Case or Disease management within a hospital setting or Home Health Care/Hospice) or experience as a telephonic Case Manager for an insurance company
Multiple state licensure (in addition to Compact License if applicable) OR ability to obtain multiple state nursing licenses required
Strong computer skills with the ability to use multiple platforms, navigate within a Windows environment, and a foundational knowledge for Microsoft Office and email. (Ability to create, copy, edit, save & send documents utilizing Word, Excel & Email)
Disease Case Management experience
Experience with Asthma, Diabetes or Heart disease treatment
Experience or knowledge of utilization review, concurrent review and / or risk management
Bilingual Spanish
Ability to work in a faced-paced environment, adapt to change, strong organizational skills and multitasking abilities are keys to success
Strong communication skills and open to constructive feedback as well as Open Coaching dialogue
Independent, team player and critical thinking skills

Registered Nurse Case Manager Resume Examples & Samples

Possess knowledge of case management or utilization review as normally obtained through the completion of a Bachelor's degree in case management or health care
Hold a current Registered Nurse (R.N.) license in Arizona
Possess a Basic Life Support (BLS) for Health Care Providers certification, required prior to employment
Demonstrate a proficiency level typically achieved with 5 years clinical experience

Registered Nurse Case Manager Resume Examples & Samples

Knowledge of case management or utilization review as normally obtained through the completion of a Bachelor'sdegree in case management or health care
Current Registered Nurse (R.N.) license in Arizona
Basic Life Support (BLS) for Health Care Providers, required prior to employment

Registered Nurse Case Manager Pool Resume Examples & Samples

Basic Life Support (BLS) certification is required
Working knowledge of care management, acute care and/or home care environments, community resources and resource/utilization management
Critical thinking skills, problem-solving abilities, effective communication skills, and time management skills
CCM, highly preferred

RN Registered Nurse Case Manager Resume Examples & Samples

Although Registry positions normally do not offer guaranteed hours, this is a position which will require a full time 40hr commitment from the successful candidate for up to 6 months
Shifts are Monday thru Friday
A minimum of 5 years clinical med/surg (inpt) knowledge
Prior auth processing is desired but not necessary
Health plan knowledge such as previous work history with Health Net, United Health Care, AHCCCS, etc. is desirable
Microsoft Office knowledge
Knowledge of how to use the internet for medical research-ex: CMS website

Registered Nurse Case Manager Prn-utilization Review Resume Examples & Samples

Initiates timely admission and continued stay reviews per Department Standards
Works well autonomously and as a team member
Excellent communication skills (oral and written) and customer service oriented
Promotes and maintains collaborative working relationships
Graduate of an accredited nursing program, diploma, associate degree or baccalaureate program

Registered Nurse Case Manager Resume Examples & Samples

This position performs case management, utilization review and discharge planning responsibilities
Admission/pre-admission screening for appropriateness of admission and continued stay
Concurrent review of inpatients; assess patients for discharge planning and community resource needs
Assist in identifying problem diagnoses and practice patterns
Participates in committees as required
Performs case management assessment and makes appropriate referrals as needed
Performs other special duties within the case management scope of work as assigned by the Department Director
Current TX RN license or applicable compact state
BSN Degree
Current enrolled in a BSN program will be considered
Minimum 2 years of direct patient care in an acute care setting
Some experience with discharge planning and utilization review proficiency is necessary to be considered for this role
Minimum two years acute care case management experience

Registered Nurse Case Manager Resume Examples & Samples

Assesses by interview and charts review discharge needs of all high-risk patients (and others referred). Identifies resources available to address the needs identified, coordinate referrals and document plan
Utilize community resources to support patient’s post hospital needs. Documents choice in available resources has been offered
Performs admission and continued stay reviews. Provides clinical information to payers upon request for certification and reimbursement of care. Discusses alternate level of care with physician. Refers cases not meeting acute care criteria to Physician Advisor as needed
Facilitates and or provides education of hospital staff, physicians, patients and caregivers for purposes of efficient resource utilization
Keeps current of requirements by JCAHO, HCFA and other state/federal agencies on provision of care, planning and documenting
Required: Current Texas licensure as a Registered Nurse

Registered Nurse Case Manager Resume Examples & Samples

Education:Graduate of an accredited diploma, associates, or baccalaureate degree nursing program
Experience:Minimum of 3 years clinical experience in area in which Case Management will be performed
Required:Current Texas licensure as a Registered Nurse
Preferred:Bachelor of Science in Nursing

Registered Nurse Case Manager Resume Examples & Samples

Current and unencumbered license to practice as a Registered Nurse specific to that state the employee is assigned to work by the company
Demonstrated knowledge of the appropriate skills for communicating with individuals of all ages. Excellentinterpersonal skills including verbal and written communication skills
Valid Driver’s License
Reliable transportation and agency required liability insurance

Registered Nurse Case Manager Days Resume Examples & Samples

Concurrent review of inpatients
Assess patients for discharge planning and community resource needs
Identifies under-utilization and over-utilization of services
Communicates with care providers of appropriateness of admission, treatment , and length of stay; monitors patients for appropriateness of level of care
Acts as patients' advocate; performs case management assessment and makes appropriate referrals as needed
Provide social service consult and follow up as needed
Assess for quality of patient care
Acts as consultant to the Health Information coders when clinical questions arises
Current Texas State RN license or compact license is accepted
Bachelor of Science Degree in Nursing preferred
Three years of direct patient care nursing experience in an acute care setting preferred
Prior Case Management experience preferred

Registered Nurse Case Manager Pool-tier Resume Examples & Samples

Requires current Registered Nurse (R.N.) license in Arizona
CCM, highly preferredTier 3: Minimum of 10 shifts/four weeks to include a minimum of 4 weekend shifts (out of 8 possible weekend days)/four weeks and 1 major and 1 minor holiday/year
RN Case Managers must have at leasttwo areas of competency in order to FLOAT
Major Holidays: Thanksgiving, Christmas Day & New Year’s Day (must work a different major holiday each year)
Minor Holidays: Memorial Day, 4th of July, Labor Day (Minor holidays may also include difficult to staff days or other days as defined by Leadership: e.g. Halloween, Valentine’s day, Easter, Mother’s/Father’s day, Super Bowl Sunday, St. Patrick’s Day, Day after Thanksgiving, etc.)
Offered as a flat rate wage Tier 3 = $44.00/hour, non-negotiable
Benefits not included
Evaluates the medical necessity and appropriateness of care, optimizing patient outcomes. Assesses patient admissions and continued stay utilizing standard criteria. Identifies issues that may delay patient discharge and facilitates resolution of these issues

Registered Nurse Case Manager Days Resume Examples & Samples

Identifies and resolves barriers that hinder effective patient care
Collaborates and consults with physicians on patient's progress and discharge planning needs
Performs utilization review ensuring admissions meet criteria for appropriateness of care and medical necessity
Maintains knowledge of resources and facilities available to patients and family members
Collaborates with personnel at other facilities to coordinate smooth and effective patient transfers and transitions

Registered Nurse, Case Manager, Home Health Resume Examples & Samples

Responsible for coordination of patient care for assigned caseload. Will manage the clinical aspects and oversee the plan of care for patients along with discharge planning
Acts as a resource for other clinicians including Registered Nurses, Licensed Practical Nurses, Home Health Aides, Physical Therapists, etc., who may be working on a particular home care case for which the primary RN is responsible for managing
Regularly re-evaluates patient nursing needs

Registered Nurse, Case Manager, Hospice Resume Examples & Samples

Responsible for coordination of patient care for assigned caseload. Will oversee the plan of care for patients along with discharge planning
Develops a plan of care, which establishes goals based on nursing diagnosis and incorporates therapeutic and preventive nursing actions. Includes the patient and the family in the planning process
Initiates appropriate preventive nursing procedures. Administers medications and treatments as prescribed by the physician
Provides health care instructions to the patient as appropriate per assessment and plan of care
Responsible to communicating with all disciplines involved in the patient’s care (i.e., Social Work, Chaplain, Hospice

Registered Nurse Case Manager PRN Resume Examples & Samples

Performs continuous assessments and evaluations to ensure patient is progressing towards desired outcomes
Assesses and responds to patient/family needs by coordinating efforts of other team members
Manages the process to review and, as appropriate, appeal denials received from payors
Bachelor's of Science in Nursing preferred

Registered Nurse Case Manager Resume Examples & Samples

Must be a licensed driver with an automobile that is insured in accordance with state or organization requirements and is in good working order
Minimum of two years experience, at lease one of which is in the area of public health, home care, or hospice nursing is preferred
Self directed and able to work with minimal supervision
Management experience not required. Responsible for supervising hospice aides
Demonstrates excellent observation, problem solving, verbal and written communications; nursing skills per competency checklist

Hospice Registered Nurse Case Manager Resume Examples & Samples

Registered Nurse licensed in the State of Colorado
Graduate of an Associate’s degree Nursing program
Valid driver’s license and active auto insurance
Basic Life Support (BLS) competency
At least 2 years of experience in hospital, Home Health and/or Hospice
Infectious positivity and interpersonal skills
Ability to document within the HomeCare HomeBase (HCHB) electronic medical record
Mastery of time management skills to effectively case manage
3 years experience in Home Health and/or Hospice
HomeCare HomeBase experience and understanding

Registered Nurse Case Manager Days Resume Examples & Samples

Communicates with care providers of appropriateness of admission, treatment, and length of stay
Monitors patients for appropriateness of level of care
Participates in development and implementation of QI programs
Acts as patients' advocate
Assess for quality of patient care; acts as consultant to the Health Information coders when clinical questions arises
Assist in the development of case management policies and procedures
Prepares education materials for in-service and training of physicians, hospital personnel and the community as needed
Enters data and maintains the appropriate reports
Current Texas Licensure as a Registered Nurse required. Compact license is accepted
Current Healthcare Provider CPR issued by the American Heart Association required
Two years of direct patient care experience

Registered Nurse Case Manager Resume Examples & Samples

Under the general supervision of the Director, Case Management, the Clinical Case Manager is responsible for assisting in the implementation of the Case Management Program to ensure ongoing assessment of patient care delivery according to established standards
Coordinates patient care services provided in the Intensive Care/PCU Unit in collaboration with the Director on designated shifts
Functions as a resource person for staff members and assists in necessary education of individual members of nursing staff with a focus on promoting clinical competence in the provision of critical care nursing
Assumes responsibility for the quality of nursing care provided by the Intensive Care/PCU Unit on designated shifts including the implementation of programs to improve this quality in collaboration with the Director
Ensures adherence to standards in the Intensive Care Unit/PCU based on Administrative Operational Standards, Nursing Administrative Standards, Human Resource Standards, and Intensive Care/PCU Unit Standards with collaboration with the Director, ICU/PCU, or Chief Nursing Officer in unusual situations
Consults and coordinates with healthcare team members to assess, plan, implement, evaluate, and modify the plan of care, as indicated by the patient’s responses and conditions
RN licensure by Texas Board of Nursing
Minimum for 3 years of clinical practice with emphasis on leadership and management exp
Previous experience in critical care nursing with certification (CCRN) preferred
BLS and ACLS from the American Heart Association required
Current licensure in Texas as a Registered Nurse with Bachelor of Science in Nursing preferred
Experience in health care delivery systems with focus on Case Management or Performance Improvement preferred

Home Health Registered Nurse Case Manager Resume Examples & Samples

RN, licensed in the state of Oregon, and with at least 1 year home health and/or hospice experience
Strong team skills
Flexible--responds well to changing priorities and conditions
Knowledge of the duties and functions of the home health and hospice agency and its relationship to the healthcare community

Hospice Registered Nurse Case Manager Resume Examples & Samples

Regularly assesses and reassesses the nursing needs of the Hospice patient
Provides dietary counseling
Provides Hospice nursing services, treatments and preventive procedures
Initiates nursing procedures appropriate for the patient’s Hospice care and safety
Observes signs and symptoms and reports to the physician and IDG members any unexpected changes in the patient’s physical or emotional condition
Teaches, supervises and counsels the Hospice patient and family members about providing care for the patient
Supervises and trains other nursing service personnel
Develops and re-evaluates the patient/family care plan in conjunction with IDG to meet needs and maintain continuity of care
Performs specific nursing procedures as needed (e.g., treatments, management of symptoms) following doctor’s orders
Attends team conferences
Maintains records as required by Hospice
Follows the policies and procedures of Hospice. Observes confidentiality and safeguards all patient-related information in compliance with HIPAA regulations
Always communicates to the supervisor if unable to meet a patient’s need or perform a procedure
Participates in on-call system and is responsible for providing on-call coverage when unavailable for assigned duties
Maintain skills and knowledge
Works with interdisciplinary group concept of patient care
Coordinates the implementation of the plan of care for patients residing in SNF, NF, ICF or MR
Organizes work schedule and utilizes time management to be able to attend all required meetings
Complies with agency infection control policies and protocols
Assist with orientation, teaching and training as requested
Other duties as assigned by Director of Professional Services

Registered Nurse Case Manager Resume Examples & Samples

Meets with residents and families to discuss the transfer process, anticipate treatment, expected outcome and financial implications
Determines the special needs of the resident (i.e. equipment, staff) and creates cost effective solutions
Communicates transfer, admission clinical and financial information to appropriate facility staff members. Ensure the facility is prepared for admission
Obtains the necessary information (medical and financial) to provide information relevant to the completion of the initial MDS, including back-up documentation
Facilitates resident placement based on clinical services needed, bed availability, resident/family preference, geographic location, etc
Effectively manage relationships to achieve positive process with referral sources within referring providers
Coordinate tours at facilities for referral sources
Coordinates tours and admissions conferences for potential resident s and their families
Collaborates with the resident, members of the healthcare team and, when appropriate, the resident's significant other(s) in the interest of the resident's healthcare
Consult with, utilized and initiates referrals to appropriate community agencies and healthcare resources to provide continuity of care
Ensure information is received and documented on all new resident referrals and necessary data for completion of all phases of assessment and admission are completed
Current knowledge and understanding of payments systems, HMO, PPO, Indemnity, Workers Compensation, insurance (Medicare and Medicaid, etc
Familiarity with State and Federal Regulations
Must be a graduate of an accredited School of Nursing. BSN degree highly desired,
Two years’ experience as an RN Case Manager preferred,
Must possess a current, unencumbered license to practice as a RN in the State, and current CPR Certificate

Registered Nurse Case Manager Orthopedics Resume Examples & Samples

Possesses the ability to provide a comprehensive physical assessment and triage patients according to patient acuities
Coordinates the surgical schedule and prioritizes cases accordingly
Coordinate patient care between clinic, operating room and discharge activities and coordinate requests for specialized Operating Room equipment
Work closely with the Orthopedic Residents, providing guidance and direction regarding the day to day operation of the Orthopedics Program
Consistently demonstrates sound clinical judgment and the ability to effectively provide and/or direct the care provided by team members for patients and modifies and updates the plans of care/treatment plans for patients
Identifies significant patient care problems and sets priorities for their management
Provides and directs nursing care for clients with complex nursing care needs; i.e. multi-system health care issues, complex psychosocial issues, etc
Demonstrates leadership qualities through collaboration with others
Participates in studying, identifying, evaluating and implementing creative process and system improvements that facilitate the mission of the Medical Center at the program or service level and which can be documented through demonstrated outcomes
Demonstrates understanding of patient rights, policies relating to patient rights (i.e. Advanced Directives, DNR, patient confidentiality) and understanding of ethics for the Federal employee
Acts as a patient advocate, guides, directs or supports co-workers regarding ethical issues and makes appropriate referrals when issues are suspected or identified; i.e. knowledgeable regarding the chain-of command and ensures referrals are made to the Medical Ethics Committee when appropriate
Completes assignments in a timely and effective manner and follows safety protocols designed to reduce/eliminate employee risk of injury
Guides and ensures that other health team members follow established safety protocols that have been designed to reduce/eliminate the risk of injury and when in charge, makes assignments in a manner that appropriately utilizes and optimizes the resources available for the shift
Consistently demonstrates consideration and/or utilization of restraint alternative and/or utilizes the least restrictive form of restraint possible
Supports and enhances client self-determination
As well as other assigned duties
Orthopedic experience is preferred
Critical Care experience is strongly preferred

Registered Nurse Case Manager, Area Resume Examples & Samples

Conducts telephonic, face-to-face or home visits as required
Maintains ongoing member case load for regular outreach and management
Collaborates with RN case managers/supervisors as needed or required

Registered Nurse Case Manager Resume Examples & Samples

Completes face-to-face comprehensive assessments of members per regulated timelines
Facilitates comprehensive waiver enrollment and disenrollment processes
Develops and implements a case management plan, including a waiver service plan, in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals
Promotes integration of services for members including behavioral health care and long term services and supports, home and community to enhance the continuity of care for Molina members
Assesses for medical necessity and authorize all appropriate waiver services
Evaluates covered benefits and advise appropriately regarding funding source
Facilitates interdisciplinary care team meetings for approval or denial of services and informal ICT collaboration
Assesses for barriers to care, provides care coordination and assistance to member to address psycho/social, financial, and medical obstacles concerns
Identifies critical incidents and develops prevention plans to assure member's health and welfare
Note for RN's: May have additional duties, such as providing consultation, recommendations and education as appropriate to non-RN case managers; working cases with members who have complex medical conditions and medication regimens; and/or conducting medication reconciliation when needed
50-75% travel required
At least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports
Active, unrestricted State Nursing license (RN/LVN/LPN) OR Clinical Social Worker license in good standing
Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation
1 year experience working with population who receive waiver services

Registered Nurse Case Manager for ., OH Area Resume Examples & Samples

Facilitates interdisciplinary care team meetings and informal ICT collaboration
Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts
RNs are assigned cases with members who have complex medical conditions and medication regimens
RNs conduct medication reconciliation when needed

Registered Nurse Case Manager General Surgery Resume Examples & Samples

Provide routine patient care and management in the clinic setting. Perform basic nursing procedures including, but not limited to, ostomy care, wound care, and dressing changes
Triage patients with acute and chronic complaints, in consultation with General Surgery clinical staff and according to standardized procedures
Case management for patients with complex needs to coordinate and facilitate their General Surgery care (e.g. consultation for referral patients from outside of VAPAHCS, oncological patients receiving multimodal therapy, Bariatric Surgery patients, Breast Surgery, integrating care with other medical specialties)
Serve as a primary General Surgery section patient advocate. Provide service recovery to address patient and family concerns
Current BLS provider card issued by American Heart Association (AHA) or Military Training Network (MTN)
Four (4) years of recent surgical setting (inpatient, outpatient, and clinic) RN practice experience
Experience in ostomy care, wound care, dressing changes, suture/staple removal
Current Ostomy Care Certification or are willing to obtain within one year of hire
RN experience in coordinating care for surgical patients
OF-306 Declaration For Federal Employment: http://www.opm.gov/forms/pdf_fill/of0306.pdf (Required if selected)
Copy of Transcripts (Official transcripts will be required if selected)

Registered Nurse Case Manager Plastic & Reconstructive Hand Surgery Resume Examples & Samples

Provide routine patient care and management in the clinic setting. Perform basic nursing procedures including, but not limited to, wound care, dressing changes, post-op care including suture removal
Triage patients with acute and chronic complaints, in consultation with Plastic & Hand Surgery clinical staff and according to standardized procedures
Request and follow up on diagnostic studies as indicated per request of Plastic & Hand Surgery providers
Serve as primary Plastic & Hand Reconstructive Surgery section patient advocate. Provides service recovery to address patient and family concerns
Instructed in treatment of life threatening situations where a physician is not immediately available
Four (4) years of recent medical-surgical unit RN practice experience
One (1) year of recent Case Management experience
Certification in Case Management (RN-BC) or CCM (Certified Case Management)
Resume (Required for ALL applicants)
Non-Award SF-50 (VA, other Federal Employees, and Reinstatement eligible)
VA Form 10-2850a - Application for Nurses and Nurse Anesthetists (Available at http://www.va.gov/vaforms/medical/pdf/vha-10-2850a-fill.pdf) (Required if selected)

Registered Nurse Case Manager Behavioral Health Interdisciplinary Program Bhip Resume Examples & Samples

Makes follow up calls to Veterans who no show or cancel scheduled appointments
Does assessments with vital signs on all Veterans with scheduled appointments with BHIP providers and informs providers of any abnormal findings and completes clinical reminders
Fills medication boxes and provides education to Veterans about their medications. Ensures that Veterans have adequate refills on their medications and works with provider when new refills are needed. Provides phone follow up with Veterans who have been placed on new medications to monitor therapeutic effects and assess for side effects or adverse reactions
Works closely with other BHIP members in developing a comprehensive treatment plan and providing follow up phone calls or face to face visits as needed or suggested by team
Participates in and contributes to regular meetings with BHIP team and MH Staff, which may be on a daily and ad hoc basis, as well as weekly team meetings with the ACOS, Mental Health
Monitors providers clinic to ensure that Veterans needing to be seen right away can be seen without delay
Participates in patient safety and quality improvement processes

Registered Nurse Case Manager Hospice Resume Examples & Samples

Collaborate with IDG members to provide continuous assessment of assigned patients, initiate appropriate nursing actions, and evaluate the results of these actions
Facilitate the implementation of nursing interventions, preventive and therapeutic nursing procedures. Provide direct patient care as necessary
Assume a leadership role to facilitate interdisciplinary coordination and collaboration
Provide appropriate information and explanation to patients family/caregivers. Facilitate patient and family education
Evaluate the effectiveness of teaching to promote quality patient/family/caregiver outcomes, and ongoing professional development of hospice staff
Develop visit frequencies in accordance with patients needs and acuity, reviewing at least weekly and adjusting as needed
Participate in evening/weekend call as required, conducting on-call services in a clinically competent and responsive manner
Facilitate the quality assessment, performance improvement (QAPI) process

Registered Nurse Case Manager Resume Examples & Samples

For Nursing, must possess minimum of an Associate Degree in Nursing, RN licensure with BSN preferred. A diploma is acceptable only in those states whose minimum requirement for licensure or certification is a diploma rather than an Associate Degree
For all other eligible licensed or certified health care professionals, must possess a minimum of a baccalaureate degree and graduate degree is preferred
2 years of rehabilitation experience preferred
Ability to coordinate, analyze, observe, make decisions, and meet deadlines in a detail-oriented manner

Registered Nurse Case Manager Resume Examples & Samples

Current / Good Standing :Registered Nurse (RN) license in the state of CA ***
Continuing education credits maintained as required by state of practice required
Minimum of three (3) years’ experience in clinical nursing preferred
Minimum of one (1) years experience in renal nursing or case management /and or case coordination ** preferred
Previous experience in healthcare performance coaching preferred
Bilingual ( English/Spanish ) is preferred but not required **
Current driver’s license in state of CA with positive driving record and able to meet requirements of insurance coverage required
Will require travel within Palm Springs, Banning, and Marino Valley, CA **
Functional proficiency with DaVita specific clinical software programs, required within 90 days of employment

Registered Nurse Case Manager Pain Management Resume Examples & Samples

BSN Degree is highly desirable; National certification in Case Management is preferred
A minimum of five (5) years of complex nursing experience highly desirable with 2 years of case management experience preferred
Demonstrated ability in previous assignments to make critical decisions in stressful environments
Demonstrated ability to work independently and exercise good judgment with minimal supervision
3) Whether you were referred to the selecting official for further consideration
) A copy of any pertinent certifications
) Form OF-306: Declaration of Federal Employment
) Copies of transcripts to validate each level of academic achievement (diploma, ADN, BSN, MSN, etc.) and all licensure/national certification documentation
*Application materials will not be accepted by e-mail. ***

Registered Nurse Case Manager Resume Examples & Samples

Promotes hospice philosophy
Communicates identified needs and potential solutions to supervisor
Completes routine and emergency assessments on each patient as indicated by departmental policy
Coordinates clinical and psycho-social and spiritual services as indicated by Plan of Care through case management
Records observations, treatments, and other pertinent information
Communicates with IDT, Medical Director and Attending Physician as directed regarding measures to alleviate symptoms, and monitors response to measures implemented
Provides physical and emotional interventive care to support the patient and family in period of crisis through case management with the psycho-social team
Prevents unwarranted hospitalizations by meeting patient and family needs in the home
Coordinates Case Management of routine and emergency patient care
Collaborates with IDT meet needs of patient for clinical and psycho-social interventions
Collaborates with IDT to coordinate hospice care for the patient and family to ensure appropriateness, continuity, and quality of care
Updates the POC for IDT
Develops and updates care plans following each POC change and ensures updates are made from the psycho-social staff
Assists in identifying the need for intervention of other IDT members
Effectively communicates patient and family needs to IDT
Educates patient and caregiver regarding
Care of patient
Disease process
Dying Process
Symptom control
Wound care
Admits patients
Explains hospice services and Medicare benefits to patients and families
Obtains the Election of Benefits
Completes referral and admission assessments as requested
Maintains appropriate communication
Keeps physician and Medical Director informed of patient needs and condition
Ensures documentation at bedside
Notifies other IDT members of physician concerns and suggestions
Submits appropriate documentation and paper work to contracted facilities at completion of patient visit
Completes and submits IDT Narratives, time logs, and all required documentation by 10 A.M. the following morning
Supervises the care given by Licensed Practical Nurses and Hospices Aides

Registered Nurse Case Manager Resume Examples & Samples

Promotes home health philosophy
Coordinates clinical and all disciplines(PT,OT,MSW or HHA) as indicated by Plan of Care through case management
Provides physical and emotional interventive care to support the patient and family in period of crisis through case management
Collaborates with IDT to coordinate home health care for the patient and family to ensure appropriateness, continuity, and quality of care
IV therapy
Explains home health services and Medicare benefits to patients and families
Explains Home bound criteria and skill need to patient and families
Completes and submits clinical notes and Oasis, time logs, and all required documentation by 10 A.M. the following morning
Supervises the care given by Licensed Practical Nurses and Home Health Aides

Registered Nurse Case Manager Resume Examples & Samples

Current state of Oregon Registered Nurse (RN) licensure and graduation from an accredited school of nursing
3-5 years of clinical experience
Working knowledge Medicare criteria for skilled nursing services or home health/medical equipment services
Demonstrated ability to work cooperatively in a multi-disciplinary team
Current recognition by a national professional organization in case management must be obtained within 2 years of hire date
For RNs, graduation from a Bachelor's of Science in Nursing (BSN) program
Home health, skilled nursing facility and/or community health nursing (OR) clinical social work
1 year of managed care experience and/or utilization management experience

Registered Nurse Case Manager Resume Examples & Samples

Graduate of an accredited Bachelors Nursing degree program or completion of an accredited Nursing program with a Bachelors degree or higher in a health care field
Applicants without a BSN degree must actively pursue and attain a BSN within five years of hire
Current license to practice as a Registered Nurse in the State of Washington
A minimum of three years registered nursing experience in an acute care hospital
Ability to employ advanced communication, negotiation, and interpersonal skills with all levels of internal and external customers
A minimum of one year of hospital case management experience
Knowledge of funding, resources, services, clinical standards and outcomes

Registered Nurse Case Manager Resume Examples & Samples

Current Washington State Registered Nurse License
Minimum of five (5) years clinical experience
CPR or BLS certification within 6 months of hire
Previous experience in utilization review/case management
Computer skills: typing, email, and word processing
Certified case manager

Registered Nurse Case Manager, Home Health Resume Examples & Samples

Conduct a comprehensive patient assessment(s), initial, reassessment, discharge and ongoing of the client's needs, including OASIS assessment at appropriate time points. (G171, G172, G331, G335) Achieve and maintain OASIS assessment accuracy. Communicate findings to ordering physician. Validate medical diagnoses and submit preliminary ranking. Identify and prioritize the problems/needs of patient. Establish a physician-directed, individualized treatment plan in conjunction with Utilization Management staff
Demonstrate support of the Agency's Mission, Principles, and Values, Ethics, & Standards of Behavior
Educate and require adherence to performance improvement processes and initiatives
Establish and manage patient Plan of Treatment for all disciplines/services, from assessment to discharge under direction of physician for a defined caseload. Obtain physician orders for all service and treatment. Execute the plan of treatment and revise as necessary in conjunction with the ordering physician. (G162, G173) Coordinate services with other disciplines (G176). Inform the physician and other staff of changes in patient condition (G176). Determine preliminary ranking of medical diagnoses and assure accuracy ongoing
Expand knowledge and expertise through educational resources and literature review
Model and mentor effective leadership and management
Plan and coordinate care to meet ongoing needs at time of discharge. Complete Discharge Instructions
Provide clinical services and/or treatments requiring substantial and specialized nursing skill. (G174) Complete all education requirements. Maintain Agency specialty clinical competencies
Responsible for achievement of optimal patient outcomes. Identify and prioritize the problems/needs of the patient. Develop individualized, patient specific, measurable/realistic outcomes. Initiate appropriate preventive and rehabilitative nursing procedures. (G175) Consult with supervisor when variances to outcomes and/or utilization patterns are identified. Educate the patient and family in meeting nursing and related needs. (G177) Utilize appropriate patient teaching methods that are age specific, culturally sensitive, language specific, and appropriate to level of education and physical disability. Identify, initiate and coordinate referrals to internal and external resources, including specialty staff. Evaluate outcomes of care and validate declines
Responsible for concise, accurate and timely documentation of patient observations, care, treatment and outcome attainment. Prepare clinical and progress notes. (G176)
Responsible for meeting/exceeding Customer Service initiatives. Initiate activities to report and/or resolve customer complaints. Establish and maintain customer relationship focus with all internal and external customers
Responsible to manage the provision of safe and effective care for a defined caseload. Assure continuity of care. Prioritize patients for emergency preparedness. Maintain productivity standards. Instruct, direct and document supervision of License Practical Nurse in patient plan of care. (G178) Develop and modify Home Health Aide Plan of Care as indicated. Assign Home Health Aide to a specific patient. Document supervision of Home Health Aide services according to regulation. Review HHA documentation to assure compliance to HHA plan of care. Observe care being provided in the home during initial supervisory visit to assure adherence to care plan, rights, and safety
Act 34 Criminal Clearance
Cardio Pulmonary Resuscitation

Registered Nurse Case Manager, Home Health Resume Examples & Samples

Conduct a comprehensive patient assessment(s), initial, reassessment, discharge and ongoing of the client's needs, including OASIS assessment at appropriate time points. (G171, G172, G331, G335) Achieve and maintain OASIS assessment accuracy. Communicate findings to ordering physician. Validate medical diagnoses and submit preliminary ranking. Identify and prioritize the problems/needs of patient
Establish a physician-directed, individualized treatment plan in conjunction with Utilization Management staff
Manager third party authorization process to avoid bad debt
Provide third party payer updates as requested for visit authorization within the specified time frames. Assure third party payer authorizations are obtained for specific payers. Verify third party payer coverage with patient on an ongoing basis
Graduate of a School of Nursing accredited by NLN required. Bachelors Degree in Nursing is preferred
Minimum of one year work experience. Internal: Minimum 1 year satisfactory performance as RN II preferred. Demonstrated OASIS competency
Competency in a minimum of one clinical specialty area

Registered Nurse Case Manager Resume Examples & Samples

Adhere to infection control principles, standards, policies and procedures
Maintain and protect customer and Agency confidentiality
Maintain personal productivity by demonstrating satisfactory attendance and punctuality
Manager third party authorization process to avoid bad debt. Provide third party payer updates as requested for visit authorization within the specified time frames. Assure third party payer authorizations are obtained for specific payers. Verify third party payer coverage with patient on an ongoing basis
Promote personal and co-worker safety during work duties
Represent and participate in Agency professional and community activities as requested
Graduate of a School of Nursing accredited by NLN required
Bachelors Degree in Nursing is preferred
Minimum of one year work experience
Internal: Minimum 1 year satisfactory performance as RN II preferred. Demonstrated OASIS competency. Competency in a minimum of one clinical specialty area
Competency in a Windows based environment
Access to transportation in the Agency service area with valid Pennsylvania drivers license and auto liability insurance

Registered Nurse Case Manager Resume Examples & Samples

Must possess and maintain valid CPR certification while employed in a clinical role
Has sufficient endurance to perform tasks over long periods of work hours
Must be a licensed driver with an automobile that is insured in accordance with state and/or organization requirements and is in good working order. Ability to travel to all business locations

Registered Nurse, Case Manager Resume Examples & Samples

Currently licensed as a Registered Nurse in the state(s) in which they are practicing
Demonstrates ability to work independently and execute own workload
One-year recent nursing experience required; home care experience preferred

Registered Nurse Case Manager Resume Examples & Samples

Responsible for providing leadership for the clinical support team
Assists providers in communications with their patients and other healthcare providers
Implements protocols and systems for Quality Improvement activities
Works collaboratively with clinic operations
Reviews provider’s incoming communication/tasks
Reconciles tasks with RN Scope of Practice and/or delegates as appropriate
Makes nursing decisions based on interpretation of data and assessments
Assists in effective systems for triaging walk-in patients
Serves as a leader of the healthcare team
Discusses patient findings and progress toward outcomes with providers and other members of the healthcare team
Participates in problem identification and resolution
Prioritizes, delegates assignments appropriately and complies with the standard of practice
Confronts difficult or conflict situations constructively and seeks appropriate assistance
Leads and directs others through change processes
Champions new ideas
Shares responsibility and authority with subordinates and holds them accountable for performance
Acts as a resource and mentor to new employees
Demonstrates professional and supportive behavior
Practices customer service standards
Assures that policies, protocols, safety guidelines and facility requirements are met
Supports audit activities
Assists in managing performance improvement projects
Provide dispensary care according to clinical medical protocols
Dispense medications as prescribed by EVCHC providers
Provide required information and education regarding medications and drug interactions
Accurately complete all required documentation
Ensure that updated educational materials and patient instruction sheets are available and included with every prescription
As necessary, consult with Medical Director and/or Consulting Pharmacist regarding drug interactions
Take part in medical updates and training as appropriate; comply with continuing medical requirements
Participate in team meetings as required
Assistance with quality improvement activities as required
Completion of accredited Registered Nurse training program, and current license as an RN in the State of California
Must relate well to all cultural and ethnic groups in the community
Community Health experience preferred
Duties are performed primarily in a site/office setting
Work requires periods of standing, sitting, lifting, turning, twisting, walking, pushing, pulling, reaching, speaking, hearing, seeing and ability to articulate clearly, use of hands to finger, reaching with hands and arms
Ability to stand, sit, stoop, kneel, and bend in order to speak to patients
Frequent significant decisions to ensure the operations of the agency
Ability to communicate, in a positive manner, with all levels of staff

Registered Nurse Case Manager Resume Examples & Samples

Assess for appropriate level of care and admission status utilizing nationally recognized criteria such as InterQual/Milliman
Promotes appropriate documentation which will accurately support the severity of illness and intensity of service
When documentation is not reflective of the severity of illness and intensity of service, immediate discussion with the admitting physician will be provided to educate and facilitate the necessary documentation
The CM will demonstrate the ability to discuss difficult/sensitive subjects with physicians in an articulate and professional manner
Confirm the diagnosis identified as the reason for admission
Request documentation to support admission
Confirm that the clinical symptoms/treatment, including severity of illness and intensity of service per Interqual guidelines for admission are met, as well as, payer guidelines for admission and continued stay. Maintains up to date knowledge of payer guidelines including Medicare, Medicaid, Commercial Insurance, Managed Care Plans, etc
Confirm that the defined level of care/status is appropriate for the identified treatment plan
Identifies readmissions and makes the appropriate referrals as needed to meet the needs of the patient. Documents Readmission Assessments appropriately and timely
Documents Avoidable Days appropriately and timely
Enters the Utilization Management review on all screened admissions
Continues to reassess observation cases and outpatient in a bed cases throughout the length of stay, with the assistance of the ED/Admissions case managers, for potential conversion or discharge
Enters the concurrent Utilization management reviews on all payer cases requiring clinical information. Clinical information is faxed or transmitted electronically as needed
Communicates to registration the need for inpatient authorizations
Communicates to the Director of Case Management, House Supervisor, CNO or CFO as needed when a patient does not meet admission screening guidelines or continued stay guidelines and patient is admitted or remains in-house
Supports cost containment efforts through resource management, reporting variances to department Director or Manager
Proactively screens and assess patients assigned in order to determine discharge needs and establishes a viable discharge plan while collaborating with patients, families, and a multidisciplinary team
Consults and collaborates with a multidisciplinary team on complex cases
Provides consults and referrals for patients that may include: adoption, fetal demise, teen pregnancies (under 14 years of age), abused or neglected children, abused or neglected elderly, complex family issues, suicidal patients, patients with a terminal diagnosis and/or patients who are victims of domestic violence
Maintains knowledge of payer guidelines governing discharge planning; including Medicare, Medicaid, Commercial Insurance, Managed care, etc
Documents discharge plans in the patients chart and communicates the plan to all parties involved including patient, family, physician, nursing, etc
Actively participates in continuous quality improvement and is fiscally responsible when using charitable hospital resources
Case Manager follows all departmental and hospital safety policies, including identification and correction of environmental and practice safety issues
Assists in the development, implementation and evaluation of policies, standards, educational services, and programs that support the CTMC mission
Represents the Case Management Department on interdisciplinary teams. These may include committees/meetings within the organization or out in the community
Demonstrates initiatives in developing, implementing and analyzing quality improvement strategies for the case management department
Initiates activities to enhance revenue and support cost reduction and containment activities
Rounds with the physician when appropriate or upon request
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public
Effective communication among employees, and between employees, patients, visitors and supervisors is essential to ensure quality patient care and to avoid misunderstanding, errors and miscommunications which could have a detrimental effect on the health, safety and well-being of patients and co-workers. In addition to these communication and safety concerns, individuals in this position must be able to effectively review patient and related medical records, understand nurse and/or physician verbal and written instructions, read labels of medications, safety information, and hazardous chemicals. Therefore, to prevent misunderstandings, errors, and miscommunications in the provision of quality patient care and other job-related services, employees in this position are required to have the capability of fluently speaking, reading, and writing English
Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations

Registered Nurse Case Manager Resume Examples & Samples

Ability to communicate effectively, read, and comprehend complex clinical and financial data. Organize, prioritize, and manage time efficiently. Utilizes computer keyboard extensively to obtain and transmit patient, financial, medical, and psychosocial information of a confidential nature. Operates printer to obtain computer-generated information. Utilizes telephone and fax machine
Must be able to communicate effectively with a wide range of hospital personnel, physicians, patients/family members, and representatives of outside agencies. Ability to work with adolescent, adult, and geriatric patients. Must be able to communicate both verbally and in writing. Knowledge of community resources and continuum of care options
Ability to use Interqual standards for appropriateness of admissions continued stays and discharge. Knowledge of Millman and Robert’s Length of Stay guidelines. Understanding of Managed Care, Medicare and Medicaid. Ability to integrate clinical, social, and financial assessments into a patient care plan
Must be able to demonstrate understanding of national patient safety initiatives by strict compliance to all safety protocols and procedures as required by both HCA and Round Rock Medical Center. Utilizes universal precautions at all times. Works autonomously and with supervision. Maintains confidentiality of patient medical records. Regular and predictable attendance is required

Registered Nurse Case Manager Resume Examples & Samples

Bachelors of Science in Nursing, required
Minimum of three years RN clinical experience, preferred
Possess interpersonal communication and negotiation skills
Possess analytical, data management and PC skills
Current working knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement, preferred
Organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components with minimal supervision
Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families
Performs duties in amanner to promote quality patient care and customer satisfaction, while promoting safety, cost efficiency, and a commitment to Continuous Quality Improvement process

Registered Nurse Case Manager Resume Examples & Samples

Valid nurses license and appropriate education is required
1-3 years case management experience preferred
1-2 years Rehabilitation experience preferred
Two or more years of experience as a licensed clinician in an acute hospital or rehabilitation setting preferred
Ability to operate basic computer and data management software
FIM credentialed within 90 days of hire
Good organizational abilities
Ability to coordinate principle function with several interdisciplinary departments
Ability to relate well to physicians, other nursing personnel, interdisciplinary staff, patients, families/significant others, as well as personnel from outside facilities
Displays professional communication skills with all contacts
Certification: BLS must be maintained throughout employment with Terre Haute Regional Hospital

Registered Nurse Case Manager Resume Examples & Samples

Current BLS certification required or to be obtained at department expense within one month of hire
Knowledge of community resources and the ability to carry out nursing responsibilities in diverse settings under difficult situations with a diverse patient population with varying healthcare needs
Adequate knowledge to perform clinical assessments, plan patient care, manage a care plan, and educate and orient families and staff. Ability to modify services to the age and/or developmental stage of the patient
Ability to communicate effectively with physicians, multi-disciplinary health care providers, and a wide variety of staff, as well as patients and family members
Bachelors of Science Degree in Nursing (BSN) from a four-year college or university
Minimum of Three (3) years current experience in a health care environment with home health case management experience

Registered Nurse Case Manager Resume Examples & Samples

Registered Nurse with current licensure to practice nursing in the state of agency operation and possess and maintain current CPR certification
Registered Nurse with minimum one (1) year of hospice experience
Ability to work with and supervise hospice aides

Registered Nurse Case Manager Resume Examples & Samples

Graduate of an accredited school of nursing or an accredited health information technology program
Previous experience as a Case Manager; OR 3 years current clinical hospital experience; OR Nursing Management experience
Current Case Management Certification

Registered Nurse / Case Manager Resume Examples & Samples

Performs concurrent review on all patients and share all problematic cases with the Supervisor and Physician Advisor
Performs retrospective reviews as required
Participates in the maintenance of Utilization Management, Discharge Planning and Case Management statistics as required
Attends Utilization Management Committee and other staff meetings, as required
Identifies services or treatments that may not be medically necessary and make referrals to the Physician Advisor
Consults with physicians and other health care professionals on aspects of patient care
Makes referrals to other hospital departments for collaboration and assistance in discharge planning
Implements a discharge plan as necessary; document ongoing discharge planning activities in the patient's medical record according to protocol
Collaborates with appropriate professional personnel to assess patients for alternative level of care and notify appropriate hospital departments
Acts as a liaison with patient's insurance carrier (case manager, utilization reviewer) to coordinate post hospital services and referrals
Makes arrangement for non-North Shore-Long Island Jewish Home Care services including home care, Hospice, equipment, supplies and laboratory services for post discharge needs
Assists in identifying patient incidents through the NYPORTS program
Performs any and all related duties as required
Performs Clinical Care Coordination assessment within 72 hours of admission on all patients. Perform ongoing reviews every 48 hours or as necessary
Identifies problematic documentation patterns or cases and make referrals to the appropriate departments, to the Supervisor of CM-CCC and/or the Physician Advisor
High School Diploma or equivalent, required. Bachelor's Degree in Nursing or related field, preferred
PRI certification preferred

Registered Nurse Case Manager Resume Examples & Samples

Develops a care plan which establishes goals, based on nursing diagnosis and incorporates therapeutic, preventive, and rehabilitative nursing actions. Includes the patient and the family in the planning process
Management experience not required. Responsible for supervising home health aides
Excellent observation, verbal and written communication skills, problem solving skills, basic math skills; nursing skills per competency checklist

Hospice Registered Nurse Case Manager Resume Examples & Samples

Completes an initial, comprehensive and ongoing comprehensive assessment of patient and family to determine hospice needs. Provides a complete physical assessment and history of current and previous illness (es)
Prolonged or considerable walking or standing. Able to lift, position and/or transfer patients. Able to lift supplies and equipment. Considerable reaching, stooping bending, kneeling and/or crouching. Visual acuity and hearing to perform required nursing skills
Must be a licensed driver with an automobile that is insured in accordance with state/or organization requirements and is in good working order

Home Health Registered Nurse Case Manager Resume Examples & Samples

Compensation based on experience
401k with match program
RN, licensed in the state of Oregon, and with at least 1 year home health experience

Hospice Registered Nurse Case Manager Resume Examples & Samples

Must be a graduate of an approved school of nursing and licensed as a Registered Nurse in the state of employment
Must possess a valid state driver’s license, automobile liability insurance, and have dependable transportation
Minimum of one year of clinical experience is strongly preferred
Previous home health or hospice experience is preferred

Registered Nurse / Case Manager Resume Examples & Samples

Assesses the needs of all patient admissions, and checks the status of each patient from admission to discharge
Serves as facilitator and member of health care team
Identifies all barriers encountered delaying patient discharge, e.g., testing, lab and x-ray results and facilitates same in order to expedite patient discharge
Communicates with patients, physicians, nurses and social workers to identify patients who may require post discharge services. Attends rounds on patient units to screen patients for ongoing care and services needed after discharge
Develops and documents a post discharge care plan in conjunction with other members of the health care team based on initial patient assessment
Identifies an appropriate agency for providing comprehensive patient care based on patient needs and available resources
Coordinates patient discharge with physician, managed care agency, social work services, patient and family
Collects data referencing patient's progress and follows up on changes in patient's plan of care
Contacts insurance company to assess coverage and the need for prior authorization for post-discharge care and advises patients of same
Provides information to managed care agencies to enable them to provide required services to patients discharged in their care
Identifies patient/family educational needs and arranges for those needs to be met prior to discharge
Keeps abreast of developments in the field and serves as a resource to other staff
Knowledge of patient care management, theories, and practices as normally acquired through the completion of a Bachelor's Degree in Nursing or related field
PRI certification, preferred
Minimum of one (1) year utilization review/discharge planning and case management or related work experience to ensure familiarity with managed care services and federal/state regulations and trends in patient care
Strong organizational, communication and independent decision making skills required

Registered Nurse Case Manager Resume Examples & Samples

Supports the HCA Code of Conduct. Demonstrates behaviors consistent with organization mission and goals
Ensures patient/personal safety by maintaining a safe and therapeutic environment and adhering to Safety Program and Infection Control Programs
Supports hospital and departmental Performance Improvement Goals
Demonstrates and promotes Plaza Medical Center of Fort Worth’s Mission and Values philosophies
Accountability
Willing
Attitude
You First
Safety
Contributes to the organization’s goals of success
Unparalleled Service
Consistent Earnings Performance
Engaged Employees
Accepts accountability and responsibility as a member of the Case Management Department and of the patient care team
Functions effectively as a multi-disciplinary team member
Promotes personal growth and professionalism in the work environment
Acts as the communication liaison to insurance companies and post-hospital care facilities
Participates in performance improvement activities of the department and organization
Assists Social Workers with the evaluation of suspected abuse and neglect referrals; makes official reports to state and regulatory or legal agencies as required by statue or facility policy
Assists Social Workers with in developing an individual plan of care for recurring patients to include education related to accessing healthcare services at the appropriate level of care; preventative education, and community based resources, provides assistance with access to medication assistance programs
Assists Social Workers with identifying needs and development of realistic plans which include patient/family centered goals and facilitates implementing plan
Acts as a resource for the interdisciplinary team, develops, implements, evaluates, revises as needed, a discharge plan to include identified psychosocial and discharge needs
Documents professional recommendations, care coordination interventions, and case management activities to effectively communicate to all members of the health care team
Acts as a liaison through effective and professional communications between and with physicians, patient / family, hospital staff, and outside agencies
Demonstrates knowledge of regulatory requirements, HCA Ethics and Compliance policies, HIPPA and quality initiatives; monitors self-compliance and implements process changes to ensure compliance to such regulations and quality initiatives as it relates to the provision of Case Management Services
Facilitates patient throughput with an ongoing focus on quality outcomes and an efficient transition between levels of care
Tracks and trends variances barriers related to access to care; makes recommendations and develops action plans to improve processes and systems
Adheres to established policy and procedure and standard of care; escalates issues through the Chain of Command
Acts on behalf of the department in the training of new case managers and social worker’s
Graduate of an accredited professional school of nursing required; BSN or MSN preferred
Two- year’s recent experience as an RN Case Manager in an acute care facility with responsibility for discharge planning and payor systems
Expertise in data analysis; excellent verbal and written communication skills; knowledge of JCAHO and regulatory standards

Registered Nurse Case Manager Resume Examples & Samples

Ability to communicate effectively, read, and comprehend complex clinical and financial data. Organize, prioritize and manage time efficiently. Utilize computer keyboard extensively to obtain and transmit patient financial, medical, and psychosocial information of a confidential nature. Operate printer to obtain computer-generated information. Utilize telephone and FAX machine
Must be able to communicate effectively with a wide range of hospital personnel, physicians, patients/family members, and representatives of outside agencies. Ability to work adolescent, adult, and geriatric patients. Must be able to communicate both verbally and in writing. Knowledge of community resources and continuum of care options
Must be able to demonstrate understanding of national patient safety initiatives by strict compliance to all safety protocols and procedures as required by both HCA and Round Rock Medical Center. Adheres to isolation policies and procedures. Utilizes universal precautions at all times
Works autonomously and with supervision. Maintains confidentiality of patient medical records. Regular and predictable attendance is required

Registered Nurse Case Manager Resume Examples & Samples

Creates plan for care across the continuum, integrating patient/family preferences and values
Maintains ongoing dialog with supervisor and other health providers to ensure effective implementation of health plan
Minimum of two years recent, relevant acute care, discharge planning, Case Management and/or utilization review experience

Registered Nurse Case Manager Resume Examples & Samples

Current Washington State drivers license
Current CCM, NACCM or ACME upon hire or must be obtained within 1 year of employment
Proof of auto insurance
One year of long term care or geriatric nursing experience
Bachelor Nursing Degree
Medical Surgical Experience or Rehabilitation Medicine

Registered Nurse Case Manager Resume Examples & Samples

TX RN license
BSN degree/Plan to enroll or currently enrolled will be considered
2 years of direct patient care experience
Experience with discharge planning necessary to be considered for this role

Registered Nurse Case Manager Resume Examples & Samples

Graduate from accredited school of Nursing
Current Registered Nurse (RN) licensure in the State of Alaska at time of hire
2 years experience as a Registered Nurse
Bachelors of Science in Nursing (BSN)
3 years of clinical nursing experience
1 year of experience as an RN in Utilization Management-review, Case Management and Discharge-planning experience

MDS Registered Nurse Case Manager Resume Examples & Samples

Maintains current RN licensure in Washington State
Cardiopulmonary Resuscitation certification within 30 days of hire
Food Handler’s Permit within 90 days of hrie
2 years of Long Term Care, Transitional Care, or equivalent experience
Proficiency in technology
Bachelor’s Degree in Nursing (BSN)

Registered Nurse Case Manager Resume Examples & Samples

Ensure physician-specific plan of care is being followed for all patients
Propose alternative treatment to ensure a cost effective and efficient plan of care
Review all clinical findings and diagnostic reports. Correlate medical record findings with patient assessment findings
Ensures referrals and follow through are appropriate and completed in a timely manner
Minimum of 5 years clinical experience in nursing required

Registered Nurse Case Manager Resume Examples & Samples

Must be able to demonstrate understanding of national patient safety initiatives by strict compliance to all safety protocols and procedures as required by both HCA and North Austin Medical Center
Must be able to be self directed and self initiating in the performance of duties, requiring minimal supervision and direction
Must have excellent interpersonal skills, presenting in a caring and professional demeanor with patients, staff, physicians, providers and the general public in the performance of all duties
Must be discreet and maintain patient/staff confidentiality in handling sensitive information and documents
Must have good organizational and time management skills and show the ability to prioritize duties
Must be able to provide own structure in the performance of duties, soliciting supervision and guidance as needed. Must be able to manage high stress and “crisis” situations in a calm manner, responding appropriately and objectively to resolve the situation
Must be able to identify deficits and problems in own work area, analyze the situation =, develop a plan for corrective action and make decisions independently using good judgment
Must be able to communicate effectively with others both written and verbal communications
Must have regular and predictable attendance
Must be able to work with others in an effective manner using a team approach
Must be familiar with good management practices
Must be able to read and understand medical and technical documents and language related to physical medicine, rehabilitation and case management
Should be familiar with computers and word processing software
Patients served may range from adolescents to geriatrics
Must pass competency checklists for all responsibilities outlined by department/program policy
Will participate and promote positive team interactions to ensure quality patient care and interdisciplinary collaboration

Registered Nurse, Case Manager, Day Shift Resume Examples & Samples

Performs systematic assessment and reassessment of patient and family/significant other considering clinical presentation, cultural and religious influences, individual experiences, available resources, environmental factors as well as health behaviors and practices. Considers all aspects of patient/family assessment findings. Understands medical plan of care and is able to communicate pertinent findings from patient assessment. Monitors medical plan of care to determine outcome of treatment and revise patient assessment as necessary. Facilitates appropriate consults based on patient assessment to ensure timely delivery of care. Identifies cultural and religious influences on illness
Formulates the plan of care, along with the patient and family, based on communication with the attending physician(s), expected goals of care and length of stay; articulates knowledge of the plan of care through an understanding of patients diagnosis, prognosis, care needs, and desired outcomes. Considers assessment findings and collaborates with the attending physician (s)/hospitalist to establish the expected goals of care and LOS. Collaboratively participates in the development of an interdisciplinary plan of care that is individualized to the patients condition or needs. Focuses the care plan on quality of life, effective utilization of resources, and facilitates goal achievement and movement through the continuum of care. Proactively identifies hospital services and available resources to meet patients needs. Reviews patient history and re-assess prognosis and care needs to achieve desired outcomes. Assesses patient/family needs for advance care planning. Confers with attending physician/hospitalist and health care team regarding variances from anticipated plan of care
Applies customary protocols, pathways, evidence-based processes and other means of managing patient care. Utilizes protocols, pathways and order sets to formulate, communicate and ensure implementation of the patient plan of care. Utilizes multidisciplinary team to address individualized patient needs. Develops realistic goals with multidisciplinary team for patient to achieve milestone activities within appropriate timeframes. Demonstrates flexibility with plan of care to meet patient needs
Facilitates effective coordination of interdisciplinary unit/physician team (e.g., Firm on the Medical Service) rounds to identify the patients clinical management needs, progression of care, identification of barriers, appropriate discharge plan and anticipated discharge date. Assumes a leadership role to coordinate and facilitate daily interdisciplinary unit/physician team rounds, LOS management and discharge process. Collaborates with the interdisciplinary team to maintain appropriate levels of care to expedite the movement of the patient to alternate levels of care throughout the continuum. Reviews, monitors and individualizes on an ongoing basis, each patients plan of care based on diagnosis and assessment of patient/family needs. Identifies internal obstacles to efficiency and good patient outcomes and intervenes with healthcare team to eliminate when possible. Identifies a follow-up time frame to accomplish the recommended plan. Communicates patient status and needs to the next level of care for discharge planning
Ensures identification of variances and the development of appropriate contingency plans for each phase of care in the event of patient health complications or systems barriers. Communicates with the attending physician/hospitalist, patient/family and staff regarding alteration in plan. Monitors test results, patient responses to interventions, health status and makes recommendations for revisions to treatment plan based on patient need and responses. Evaluates and communicates changes in patients clinical condition timely. Documents medical plan of care and reflects patients progress in meeting prescribed plan
Effectively communicates information relative to a potential denial to the appropriate members of the health care team. Communicates timely, complete, and accurate information relative to a potential denial to the appropriate members of the health care team. Demonstrates an understanding of the peer-to-peer appeal process for authorization of acute inpatient hospitalization. Effectively monitors, documents and informs members of the health care team the outcome of the peer-to-peer appeal process. Demonstrates an understanding of CMS, Milliman Care Guidelines relative to the patients diagnosis and condition when providing a clinical review to the payor to prevent a potential denial. Effectively communicates the impact on reimbursement to the hospital for potentially denied days to the health care team. Utilizes the chief of service/physician advisor per departmental guidelines
Communicates the outcome of chart review and managed care company telephonic review with the health care team as appropriate. Conducts accurate reviews using CMS, Milliman Care Guidelines and the patients chart as the primary source of information. Performs and documents initial certification and continued stay reviews within appropriate time frame and in appropriate system. Documents obtained payor authorization in a complete, timely and concise manner. Maintains follow-up communication with payor as required for authorization of hospital stay. Notifies health care team of outcomes of communication with payor and authorization status. Notifies departmental manager of all unresolved utilization problems/issues
Acts as advocate/facilitator in all cases with insurance related issues, delays in treatments and/or diagnostic tests. Collaborates with the interdisciplinary team to maintain appropriate levels of care to facilitate movement of the patient through the continuum. Identifies and documents delays in treatment and processes. Understands basic reimbursement systems and identifies potential payor issues relative to delays in treatments and/or diagnostic tests. Assists in developing strategies to decrease avoidable days. Demonstrates and communicates the value of avoidable days and/or additional documentation to justify acute inpatient hospitalization
Educates nursing, medical and ancillary staff about care management role, relevant clinical criteria and resources available for patients, as well as regulatory and managed care requirements. Demonstrates an understanding of the vision and goals of the care management program. Demonstrates an understanding of the core functions of the care management role. Demonstrates an understanding of and effectively communicates information relative to clinical criteria and resources available for patients/families to the healthcare team. Serves as a resource for other members of the health care team by participating in or conducting formal/informal in-service education as needed. Identifies own practice abilities and limitations and obtains instruction and supervision as necessary. This includes seeking education for self development
Participates in development and implementation of appropriate patient/family education material pertinent to population served. Contributes to the development of patient/family education material for disease management. Facilitates patient/family education and understanding to prevent risk behaviors and to promote and achieve good health outcomes. Educates the patient/family and provide support in moving toward self-care. Educates and assists in facilitating patient/family access to necessary and appropriate health care services
Communicates information documented in the medical record that identifies a potential event/occurrence to the Risk Manager. Identifies quality and risk management issues; refer issues for corrective action as appropriate. Documents a potential event/occurrence and communications to the Risk Manager into Canopy within established timeframes
Contributes to the development of new strategies to address transitional planning needs of specific assigned patient populations, improved care coordination and care management delivery. Utilizes current literature to facilitate clinical/care management practice changes. Participates in the development and revision of clinical/care management practice standards. Engages in strategies to measure improvements in quality of care that directly result from care management interventions. Utilizes evaluative and outcomes data to improve care management services

Registered Nurse, Case Manager Resume Examples & Samples

Assesses patient and medical record documentation for appropriate acute admission and level of care, quality and safety indicators, and plans for discharge. Assesses patient and medical record documentation to identify medical necessity and appropriateness of admission and continued stay using pre-established clinical criteria (i.e., Milliman Care Guidelines, CMS) according to hospital policy. Ensures that the physicians documentation supports level of care. Collaborates with physician when additional documentation needed to support level of care. Communicates appropriate level of care to the health care team. Utilizes patient assessment information to identify quality and safety indicators to monitor during hospital stay. Performs initial and ongoing assessment of patient/family needs for discharge planning and communicates findings to interdisciplinary team
Works collaboratively with attending physician, consulting physician(s) and other disciplines to identify, develop, implement and coordinate an appropriate plan of care that maximizes individual patient/family preference and enhances quality, access, and cost-effective outcomes. Ensures patients individualized plan of care is collaborative and multidisciplinary by working with patient/family, attending physician/hospitalist and health care team members. Coordinates care based on individual needs, expected goals and length of stay. Facilitates interdisciplinary plan of care interventions. Communicates effectively with attending physician/hospitalist and members of health care team to enhance patient care in a positive environment
Assesses patient and family responses to interdisciplinary plan of care and care management interventions, and adapts interventions to achieve optimal outcomes. Collaborates with patient, family, interdisciplinary team for agreement with treatment goals, timeframes and coordination of care. Works with the interdisciplinary team to facilitate adjustments to the care plan to promote enhanced outcomes. Intervenes as care manager in a manner that is consistent with the established plan of care. Prioritizes and organizes interventions. Implements interventions in a safe, timely and appropriate manner
Documents assessments, findings, progress, interventions and recommendations in a care management software system and/or medical record according to established standards. Documentation meets standards in accordance with departmental and hospital policy and procedures. Documents assessments, findings, progress, interventions and recommendations in Canopy and ECIN Care Management and ICIS systems within established timeframes. Documents revisions in diagnoses, plan of care and outcomes. Documents patients responses to interventions with appropriate consideration of patient confidentiality
Supports the mission, philosophy, standards, goals and objectives of NYU Hospitals Center and Care Management Program. Contributes to the development of the goals and objectives of the Care Management Program consistent with the objectives of NYU Hospitals Center. Understands, applies and supports departmental/hospital policies, procedures and standards. Observes at all times legal and ethical considerations pertaining to patients and hospital personnel. Initiates programs for improving cost effectiveness in coordination of patient care. Assists managers to create a participative environment in department based meetings and other activities. Analyzes and develops systems to improve processes and outcomes in collaboration with managers
Facilitates timely and appropriate communication among attending physicians, nurse practitioners, physician assistants, patients, family members, other members of the health care team, external providers and payers. Refers significant clinical issues per protocol to the attending physician and/or hospitalist or to the designated consultants. Utilizes chief of service/physician advisor to address unresolved clinical and interdisciplinary issues. Participates and contributes as a regular member of interdisciplinary rounds to communicate and receive pertinent information. Utilizes critical thinking skills and assists others to identify and resolve potential and existing problems related to coordination of patient care. Determines the best method to communicate with the interdisciplinary team about different kinds of issues (i.e., direct contact, telephoning, emailing, and paging). Collaborates with attending physician/hospitalist regarding patients achievement of therapeutic regimen
Coordinates discharge appeals or issuance of Hospital Notices in accordance with State and Federal Regulations and departmental guidelines. Demonstrates an understanding of the CMS and NY State regulations for discharge appeals and issuance of Hospital Notices. Follows procedures for issuing Hospital Notices when appropriate and communicate necessary information to healthcare team relative to patients benefits. Facilitates issuance of the Important Message from Medicare within 24 48 hours before discharge and the Detailed Notice of Discharge if indicated. Effectively communicates the initiation of a discharge appeal to the health care team. Coordinates the collection of medical record documentation for review by the review agent (i.e., IPRO, managed care carrier). Communicates outcome of discharge appeal to patient/family and health care team
Participates in departmental, interdisciplinary, hospital and Medical Board committees as appropriate. Participates in departmental, interdisciplinary, hospital and Medical Board committees as requested. Represents the voice of Care Management in committee participation. Completes committee assignments as requested. Provides feedback and periodic reports to Care Management at departmental meetings and senior managers on relevant issues
Facilitates patient/family knowledge of and participation in the plan of care. Identifies long and short term needs based on a comprehensive assessment and anticipate outcomes. Proactively identifies hospital services and available resources to meet the patients needs. Ensures that patients individualized plan of care is collaborative and multidisciplinary by working with patient, physician, and health care team members. Focuses the care plan on quality of life, effective utilization of resources, and facilitates goal achievement and movement through the continuum of care. Collaborates with patient/family, physician, and health care team for final agreement with treatment goals, timeframes and coordination of care. Develops additional and contingency plan options with patient/family when planning for discharge
Serves as resource for education of patients, families, peers, staff and physicians. Facilitates patient/family teaching as soon as learning needs are identified. Provides patient/family education regarding post acute services, community resources or other as needs identified. Role models expert professional care management practices. Supports a constructive environment of learning and development of mutual respect with health care team and peers. Facilitates staff access to outside educational opportunities through sharing of program announcements, etc
Maintains current clinical knowledge in area of review and patient population. Achieves and maintains current professional licensure, national certification, and/or higher education in case management or in a health and human services profession directly related to case management practice. Maintains continuing competence appropriate to case management and to professional licensure or professional certification. Provides only case management services within scope of practice. Refers patient to another source for services outside scope of practice. Maintains continuing competence appropriate to case management and to professional licensure or professional certification. Maintains annual mandatory education requirements. Maintains membership in professional organizations
Promotes own professional growth and development in care management role. Identifies own practice abilities and limitations and obtains instruction and supervision as necessary. This includes seeking education for self development. Participates in and utilizes peer review to identify areas for improvement in practice and leadership. Achieves previously established personal professional goals. Participates in departmental education sessions
Evaluates appropriateness of alternate level of care for optimal delivery of services to the patient and for resource efficiency. Assesses the need for continued acute care services. Anticipates barriers to discharge. Assesses and re-assesses appropriate discharge plans and options based on clinical need and patient/family resources. Collaborates with other members of the interdisciplinary team to dual plan discharge options. Facilitates patient/family team meetings to discuss discharge plan and options
Participates in development of quality indicators and analysis of such indicators per departmental quality & performance improvement plan. Collaborates with members of the interdisciplinary team to develop quality indicators to measure performance improvement per departmental quality & performance improvement plan. Conducts required and initiated monitoring activities report to respective disciplines as indicated. Evaluates outcomes of monitoring, and adjusts targets and reporting as indicated. Facilitates and ensures sharing of data and outcomes with interdisciplinary team
Uses evidence-based practice to drive improvement strategies. Promotes health care outcomes in conjunction with evidence-based guidelines. Identifies areas requiring further study. Develops strategies to utilize data findings for individual patients as well as program. Recommends interdisciplinary evidence-based practice changes
Identifies cases that require peer review in accordance with the clinical indicators and criteria developed by the clinical department. Identifies trends in care, processes or services that may provide opportunities for improvement in a patient population or clinical service. Refers appropriately cases that require peer review in accordance with the clinical indicators and criteria developed by the clinical department. Takes initiative to participate in a quality/process improvement initiative. Collaborates with the interdisciplinary team to create solutions and take corrective actions to address issues resulting in variances in the plan of care

Registered Nurse Case Manager Resume Examples & Samples

Alaska State Registered Nurse (RN) license
Reliable transportation with a valid Alaska driver’s license and automobile insurance according to Alaska State Motor Vehicle laws
Knowledge of end of life (EOL) care
Pharmacology, Phlebotomy, and IV skills
Experience in Oncology, Hospice, Long Term Care or Homecare
Knowledge of infusion therapy

Registered Nurse Case Manager Resume Examples & Samples

Licensed as a Registered Nurse (RN) in the State of Alaska
2 years of professional nursing experience
2 years of Nurse Case Management experience
Ability to work with a wide range of patients of varied socioeconomic and ethnic backgrounds
Desire to work as a team member towards a common goal of delivering quality health care to low income and indigent patients
Ability to maintain records and charts and to prepare clear, concise reports

Registered Nurse Case Manager hrs / wk Resume Examples & Samples

&emsp;The ability to use critical thinking and experience to conduct a range of risk and health assessments
&emsp;Monitoring employee exposure to hazardous substances administering statutory and non-statutory health surveillance
&emsp; The ability to prescribe routine and corrective stretches for reducing and preventing injuries
&emsp;The ability to render first aid to injured employees such as giving artificial respiration, cleaning and bandaging wounds, applying heat and cold to promote healing and advising on safer mechanism of job performance
&emsp;The ability to request assistance of on-site employee health services or a physician as necessary to assist employee
&emsp;The ability to communicate about and provide general health guidance on disease management issues such as HTN, DM
&emsp;The ability to treat chronic minor reports of discomfort and related functional limitations to maintain employee performance
&emsp;Spending time “on the floor” interacting with and engaging employees, providing job coaching. Assessing the work environment for potential health and safety problems. Must be fully capable of extended mobility, climbing both in protected work environments and outdoors
&emsp;Assists in process of FMLA and ADA program application. Includes communication with outside medical providers
&emsp;Conducts, collects and documents on-site data for following official reporting. Participate in management meetings for information delivery
&emsp;Performs ergonomic job hazard analysis of work stations with identified risk factors including job process, work station and work method and follow up to evaluate effectiveness of change
&emsp;Provide on-going evaluations of work environments and provide recommendations in the workplace
&emsp;Prepares ergonomic, injury intervention, injury treatment, surveillance, FMLA/ADA reports
&emsp;Provide education and training to employees in Health, Safety and Wellness topics, including: BBP, Universal precautions, in proper lifting techniques and body mechanics, as well as other OSHA surveillance, health and wellness related topics
&emsp;Maintains the confidentiality of sensitive information and records
&emsp;The ability to maintain friendly, cordial relations with all clients and employees; maintain a positive work atmosphere by acting and communicating in a manner that results in a positive work relationship with customers, co-workers and managers
&emsp;Ability to comply with ATI standards of operations
&emsp;Ability to adhere to the Core Values of the Company
&emsp;Perform other duties as assigned by management
&emsp;At least 2 years of nursing experience
&emsp;Some experience in occupational health nursing
&emsp;Action oriented
&emsp;Approachability
&emsp;Career ambition
&emsp;Comfort around higher management
&emsp;Compassion
&emsp;Composure
&emsp;Conflict management
&emsp;Creativity
&emsp;Integrity and trust
&emsp;Priority setting
&emsp;Problem solving
&emsp;Time management
&emsp;Timely decision making
&emsp;Microsoft Office
&emsp;The ability to organize and manage multiple priorities
&emsp;Strong customer orientation
&emsp;Excellent interpersonal and communication (both oral and written) skills
&emsp;Excellent presentation skills
&emsp;Strong team player; and
&emsp;Commitment to company values
AWS

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