Nurse Care Mgr/Discharge Planner

Eastern Maine Healthcare Systems Brewer, ME
Job Details

JOB SUMMARY: The Care Manager, will assess, plan, implement and evaluate the options and services required to meet an individual's health needs during the acute encounter.

MINIMUM EDUCATION REQUIRED: Associate Degree in Nursing

PREFERRED EDUCATION: Bachelor's in Nursing

MINIMUM EXPERIENCE REQUIRED: At least 3 years of nursing experience in acute hospital care setting (med-surg, ED, critical care).

PREFERED EXPERIENCE: Experience in continuing care planning, resource management, medical necessity or care management desired. Knowledge of payers, reimbursement, DRGs and ACO desired. Revenue integrity and compliance knowledge-- Screening for medical necessity and working with Physician Advisor for secondary reviews-utilization review and utilization management. Knowledge of various levels of care including home care and all types of nursing facilities. Knowledge of CMS Conditions of Participation pertaining to Care Management and Utilization Management.

OTHER SKILLS REQUIRED: Candidate will possess the ability to prioritize, organize and multi-task, have strong communication skills, with an expert knowledge base of community resources. Must have a high level of interpersonal and communication skills and be a demonstrated team player. Must demonstrate reliability and accountability to team members and patients.

PHYSICAL REQUIREMENTS: Read and Speak English, occasionally standing for 2-4 hours, extended periods of computer and telephone use.

WORKING ENVIRONMENT: Fast paced acute hospital setting

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