RN - Outcomes Manager

Company: Integris Health
Location: Enid
Posted on: June 2, 2021

Job Description:

RN Case Mgr

Job Code: 1315

Position Summary:

The Case Manager is responsible for the clinical and financial outcomes for an assigned caseload of patients. The Case Manager facilitates patient care during the hospitalization by managing, coordinating and monitoring resource utilization to achieve optimal clinical outcomes and financial goals. The Case Manager is responsible to proactively plan, coordinate and negotiate efficient patient movement throughout the continuum of care. In general, the Case Manager functions in the role of clinician, educator, researcher, manager and advocate to serve the best interests of the system and patient. This position requires age related competencies. Performs all other job duties as assigned. Adheres to National Patient Safety Goals as appropriate based on the level of patient contact this position requires.

INTEGRIS is an Equal Opportunity/Affirmative Action Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.

Essential Functions:

The RN Case Manager responsibilities include, but are not limited to, the following:
• Assesses patient from clinical, social, financial perspective and coordinates post-discharge needs with care team.
• Functions as a clinical and financial resource for patients and interdisciplinary team members.
• Assists in clinical data collection utilizing established criteria and the InterQual system.
• Proactively performs utilization review; communicates coverage.information with third party payers, medical staff and clinical providers.

Accountability:

The Case Manager reports to the Director of the Case Management Services. The Case Manager meets established deadlines, attends required inservices, maintains staff competencies and completes required documentation; collaborates and works as a team player with all disciplines; presents a professional image to all customers and patients.

Required Physical Demands (Subject to Reasonable Accommodation):
Keyboarding/Dexterity: Frequently; activity exists from 1/3 to 2/3 of the time
Standing/Walking: Occasionally; activity exists up to 1/3 of the time
Strength (Lift/Carry/Push/Pull): Light (Exerting up to 20 pounds of force occasionally, or up to 10 pounds of force frequently)
Talking (Must be able to effectively communicate verbally): Yes
Seeing: Yes
Hearing: Yes
Color Acuity (Must be able to distinguish and identify colors): Yes

Required to be on call as scheduled by the department.
Potential exposure to infectious diseases, potential physical danger from disturbed/irate patients and families.
Emotional stress due to inability to control volume of timing of referrals and necessity to respond to a wide variety of demands and expectations from patients, families, physicians, and other health care professionals.
Occupational exposure to bloodborne pathogens and other infectious materials as defined by OSHA.

This position may have additional or varied physical demand and/or respiratory fit test requirements. Please consult the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for additional information.

Environmental Conditions:

All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.

Qualifications:
• 5 years experience in a variety of clinical settings (i.e., home health, inpatient, physician office, clinic) required.
• Experience with managed care and payer/provider requirements preferred.
• Current licensure as a Registered Nurse (RN) in the State of Oklahoma or current multistate license from a Nurse Licensure Compact (eNLC) member state. BSN preferred.
• Excellent interpersonal communication and collaboration skills.
• Computer experience required. Windows preferred.

Keywords: Integris Health, Enid , RN - Outcomes Manager, Other , Enid, Oklahoma