RN Case Manager

Location: La Crosse, WI
Date Posted: 11-01-2018
Case Management RN - Managed Care
La Crosse, WI 

Care Manager Job Summary:
  • Responsible for daily concurrent reviews, retro reviews, discharge planning, and ensures patients meet appropriate level of care based on acceptable evidence-based clinical criteria.
  • Effectively and efficiently manages patients throughout the continuum of care.
  • Works collaboratively with Hospitalists, hospital partners, hospital case managers, health plan, clinics, and other governing entities to provide holistic patient care that is focused on high quality in a cost effective way.
  • Will participate in the developing of all program material, policies and procedures related to the nurse case management program.
  • Creates program manuals and quality management policies.
  • Develops program informational and educational materials and various forms.
  • Identifies and enrolls patients into a care management program providing intensive service.
  • Conducts intakes and comprehensive assessments per health plan and department’s policy.
  • Identifies needs and develops individualized care service plans on behalf of clients.
  • Responsible for being an active participant in Case Conferences and attends Divisional Coordinators meetings.
  • Re-evaluates patients as needed and monitors the services delivered by team participants.
  • Works with hospital discharge planners and assists in the coordination of support services.
  • Attends Joint Operation Committee (JOC) meetings and various community meetings as needed.

Care Manager Background: 
  • Valid, unrestricted state Registered Nurse (R.N.) license.
  • Around 3 years of acute care, public health, or home health nursing experience, preferably working with Geriatric and/or home-health patients.
  • Strongly prefer 1-2 years of case management or utilization management experience at a Managed Care Organization (Health Plan/HMO/MSO/TPA/IPA/etc).
  • Experience in and willingness to be part of multi-disciplinary team.
  • Experience with physically or mentally impaired adults and/or geriatric population.
  • Ability to interact within all levels of the organization as well as with external contacts.
  • Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
410.983.9864 (CALL – TEXT – FAX)
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