Case Manager-RN (Salem, NH) at / RN Jobs

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Case Manager-RN (Salem, NH)

at in Salem, NH

If applying for this opportunity, please copy and paste the bottom line must have section and give a brief description to how you meet the requirements. Thank you.
Job Summary:
Through early intervention, the Case Manager will apply the six essential activities of Case Management to assure achievement of an individual's maximum level of wellness. Via appropriate, quality, cost-effective alternative care delivery, the Case Manager will explore community resources and alternative funding in order to maximize health care benefit. The Case Manager will assist an individual to self-direct and self-advocate thus assurance of an informed and empowered healthcare consumer.
Essential Duties and Responsibilities:
. Acts as an advocate and approaches clientele, according to his/her level of wellness, handicap, or injury with alternatives which may improve his/her quality of life.
. Ethically engages in the six essential activities of the Case Management process in order to assess, plan, implement, coordinate, monitor and evaluate health care delivery.
. Applies six components of case management to each of the five core areas: coordination/service delivery, physical/psychological factors, benefit systems and cost analysis, case management concepts and community resources.
. Practices case management within the full continuum of care encompassing multiple environments.
. Interacts with all healthcare systems and continues involvement with all participants to deal with an individual's broad spectrum of need.
. Applies CMSA standards of practice to an individual's holistic, healthcare, occupational, psychosocial, cultural and financial need.
. Composes confidential, timely, report mechanisms that clearly document goals, objectives, outcomes and cost benefit analysis.
. Acts as a resource to Utilization Review, Behavioral Health, Disability and Case Management team members, committees, clientele and personnel.
Education and/or Experience:
. RN Degree or Diploma :current NH/PA license, RN licensure within state of case management practice
. 3 years medical, surgical clinical experience: 3-5 years case management or disease management experience. Case Management certification
Knowledge and skills:
. Excellent written/oral/communication skills.
. Intermediate Word, Excel computer skills.
. Demonstrated success as a case manager with basic Utilization Review skills, Managed Care Software knowledge.
. Knowledge of the insurance industry, benefits coverage and claims processing.
. Ability to apply the six components to the five core areas of the case management process.
. Knowledge of case management principals, clinical guidelines, and CMSA standards.
. Ability to prioritize caseload, combining comprehensive nursing knowledge and skill with cost savings methodology and technique.
. Knowledge of health care providers, alternative funding and community resources; ability to prioritize and utilize them efficiently within the benefit plan.
. In depth knowledge of nursing care plans/skill and ability to facilitate and coordinate transition of patients with catastrophic injuries/illnesses through cost
effective, medically appropriate, alternative levels of care.
. Actively serves on an committee.
. Participates in in-service/provider education.
. Maintains membership and activity in a professional affiliation, i.e. Case Management Society of America, Case Management Society of New
England, ANA in order to promote professional development within the industry.
Must Haves:
1. RN Degree or Diploma.
2. Current RN licensure.
3. 3+ years medical, surgical clinical experience.
4. 3+ years case management or disease management experience.
5. Case Management certification, CCM. Location: Salem, NH
Compensation: Competitive
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