RN Case Manager Per Diem II
St Mary's Health System
 Nashua, NH

JOB SUMMARY # # Case management is a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual#s health needs through communication and available resources to promote quality cost-effective outcomes.# In order to meet the patient#s safety and Hospital needs, the case manager works with the physician, interdisciplinary team, the patient and the family to facilitate a plan of care in the hospital and coordinate post-hospital care to promote a balance of quality and cost-effective care.# ########### The Case Manager will: perform admission and ongoing assessments of the clinical course of patients admitted to their assigned units; identify case management needs and collaborates with the interdisciplinary team to develop, manage, and evaluate integrated patient plans of care based on available resources.# The case manager is responsible for utilization review on assigned units and for performance improvement activities when indicated.## ########### The case manager utilizes clinical experience and expertise as well as knowledge of the regulatory requirement of the federal insurer and managed care environment in collaborating on clinical interventions and addressing resource utilization issues.### ########### The case manager will possess specialized skills that include but are not limited to development of positive relationships, effective written/verbal communication, negotiation skills, knowledge of contractual or risk arrangements and ability to effect change. The case manager will perform ongoing evaluation and critical analysis, plan and organized effectively and promote client/family autonomy # QUALIFICATIONS Education: Registered Nurse with minimum of five years broad clinical experience. Bachelor of Science degree in Nursing preferred. Maintains current NH licensure. Experience: Experience in care across the continuum preferred (Acute, Skilled, Long-term care, VNA) Experience with Medicare/Medicaid and commercial insurance regulation preferred Utilization Review Experience required # # Covenant Health Mission Statement We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities. Our Core Values: Compassion We show respect, caring and sensitivity towards all, honoring the dignity of each person, especially the poor, vulnerable and suffering.# Integrity We promote justice and ethical behavior, and responsibly steward our human, financial and environmental resources.# Collaboration We work in partnership, dialogue and shared purpose to create healthy communities.# Excellence We deliver all services with the highest level of quality, while seeking creative innovation.# We are an equal opportunity, affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, disability status, gender, sexual orientation, ancestry, protected veteran status, national origin, genetic information or any other legally protected status. #

JOB SUMMARY

Case management is a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's health needs through communication and available resources to promote quality cost-effective outcomes.

In order to meet the patient's safety and Hospital needs, the case manager works with the physician, interdisciplinary team, the patient and the family to facilitate a plan of care in the hospital and coordinate post-hospital care to promote a balance of quality and cost-effective care.

The Case Manager will: perform admission and ongoing assessments of the clinical course of patients admitted to their assigned units; identify case management needs and collaborates with the interdisciplinary team to develop, manage, and evaluate integrated patient plans of care based on available resources. The case manager is responsible for utilization review on assigned units and for performance improvement activities when indicated.

The case manager utilizes clinical experience and expertise as well as knowledge of the regulatory requirement of the federal insurer and managed care environment in collaborating on clinical interventions and addressing resource utilization issues.

The case manager will possess specialized skills that include but are not limited to development of positive relationships, effective written/verbal communication, negotiation skills, knowledge of contractual or risk arrangements and ability to effect change. The case manager will perform ongoing evaluation and critical analysis, plan and organized effectively and promote client/family autonomy

QUALIFICATIONS

Education:

  • Registered Nurse with minimum of five years broad clinical experience.
  • Bachelor of Science degree in Nursing preferred.
  • Maintains current NH licensure.

Experience:

  • Experience in care across the continuum preferred (Acute, Skilled, Long-term care, VNA)
  • Experience with Medicare/Medicaid and commercial insurance regulation preferred
  • Utilization Review Experience required

Covenant Health Mission Statement

We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities.

Our Core Values:

Compassion

We show respect, caring and sensitivity towards all, honoring the dignity of each person, especially the poor, vulnerable and suffering.

Integrity

We promote justice and ethical behavior, and responsibly steward our human, financial and environmental resources.

Collaboration

We work in partnership, dialogue and shared purpose to create healthy communities.

Excellence

We deliver all services with the highest level of quality, while seeking creative innovation.

We are an equal opportunity, affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, disability status, gender, sexual orientation, ancestry, protected veteran status, national origin, genetic information or any other legally protected status.