Summary:

   Requirements:

3+ years of experience
Associate or Bachelor degree-prepared Registered Nurse with 3-5 years clinical experience in medical/surgical nursing, home care, hospital case management and/or previous utilization review experience.
Must have utilization reveiw and discharge planning experience.
Certification by a nationally recognized case management or utilization review organization preferred Must have active BLS. CCM or ACM preferred.

   Duties & Responsibilities:

Ability to conduct an assessment of patient needs, identify resources required to transition patients to the next setting, and secure the necessary resources.
Collaborate, educate, and lead an interdisciplinary team of professionals in daily care rounds/care conferences/care planning.
Excellent communication skills in written, verbal, and electronic systems such as email or with software applications currently used with the hospital.
Ability to work with community organizations to secure durable medical equipment, health insurance authorizations, arrange transportation.
Participate in the length of stay of an inpatient hospital population.
Knowledge of hospital reimbursement methods and quality measures applicable to the care management department.