Primary Function: The RN Care Manager (RN CM) performs utilization management, case management and discharge planning activities for acute care, and/or extended care patients including ambulatory and emergency department patients. The RN Care Manager works with the patient health care teams to assess patients transition/discharge planning needs, actively prevent unnecessary admissions/readmissions, and facilitate timely transitions/discharges.
Job Qualifications and Specifications: If hired after January 01, 2016, a Bachelors of Science in Nursing from an accredited nursing school, college, or university is required. Master degree preferred. Must have and maintain license as a Registered Nurse in Rhode Island. Minimum of 3 to 5 years related clinical experience as a Registered Nurse. Case Management experience or knowledge required. Knowledge is defined as applicant has 1) a Nursing Care Management Certificate of Graduate Studies or 2) demonstrates current knowledge of Care Management through applicant pre-hire assessment. As of January 01, 2016, Certification in Case Management (CCM or ACM) must be earned within 24 months of employment, prorated for part-time staff. Ability to effectively communicate with and gain cooperation of resident and attending physicians with regards to documentation needs and to effectively influence all members of the interdisciplinary care team during difficult cases to achieve appropriate resolutions. Must have effective written and oral communication. The ability to interpret medical data as documented. Utilization management, quality management and basic knowledge of third party payers is preferred. Knowledge and training in multiple computer systems required to perform position responsibilities (i.e. EMR, Microsoft Office, etc.). Participation in weekend, and holiday coverage rotation. Flexibility to cover as needed.
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