Case Manager RN Case Management PRN

HCA Derry , NH 03038

Posted 2 weeks ago

Parkland Medical Center

Parkland Medical Center is proud to provide all the care you need close to home in its 86-bed, Level III Trauma hospital in Derry, New Hampshire. Through our partnerships with The Lahey Hospital & Medical Center and the New England Heart Institute (NEHI), we bring specialized medicine by highly skilled physicians, innovative approaches to treatment and advanced technology to our communities. With convenient locations in Derry, Londonderry and Salem, we're proud to provide all the care you need close to home.

Why work at Parkland Medical Center?

Case Manager RN

Position Summary:
The Case Manager's primary duties are to provide Utilization Review and Case Management functions for the organization under the direction of the Director, Case Management and within the established policies and procedures. He/she performs preadmission, concurrent and retrospective review for all payers; completes assessments for the purpose of identifying discharge-planning needs; and provides discharge-planning services for select patient populations. Must be proficient in Interqual. The Case Manager works with physicians and other members of the multidisciplinary team to develop a plan for each patient from admission to discharge.

Essential Functions:

  • Performs continuous assessments and evaluations to ensure patient is progressing towards desired outcomes

  • Assesses and responds to patient/family needs by coordinating efforts of other team members

  • Identifies and resolves barriers that hinder effective patient care

  • Collaborates and consults with physicians on patient's progress and discharge planning needs

  • Performs utilization review ensuring admissions meet criteria for appropriateness of care and medical necessity

  • Manages the process to review and, as appropriate, appeal denials received from payers

  • Coordinates the discharge planning process ensuring involvement of all members of the healthcare team

  • Counsels with patients and family members in decision making and in meeting psycho social needs of the patient

  • Maintains knowledge of resources and facilities available to patients and family members

  • Collaborates with personnel at other facilities to coordinate smooth and effective patient transfers and transitions

  • Compiles, evaluates, and reports statistics to members of the team and utilizes the information to facilitate process improvement activities

  • Applies knowledge of the patient population served; proves age-specific care; applies knowledge of expected norms in planning care

  • Promotes internal and external customer satisfaction

  • Builds and promotes a culture of service excellence and continuous improvement

  • Attendance: works as scheduled and is compliant with Attendance and Tardiness Policy

CLICK HERE to hear from our Parkland employees on why they love their nursing teams!

EDUCATION:

  • Bachelor of Science in Nursing (BSN) Degree. Masters of Science in Nursing preferred.

  • Tuition Reimbursement Program (up to $5,250/calendar year)

  • Student Loan Assistance Program (up to $1,800/calendar Year)

EXPERIENCE:

  • Minimum of 1-3 years of experience in a hospital or health care system

  • Knowledge of CMS guidelines and experience working with payer specific guidelines and contractual rules

  • Previous UR or hospital Case Management experience

  • Assertive and persuasive communication skills, action oriented

  • Must be proficient in Interqual.

LICENSURE and CERTIFICATIONS:

  • NH RN license or valid RN Compact State License

  • HCA will pay for certification renewals once employed

At HCA, you have options. You can choose from a variety of benefits to create a customizable plan. You have the ability to enroll in several medical coverage plans including vision and dental. You can even select additional al la carte benefits to meet all your needs. Enroll in our Employee Stock Purchase Plan (ESPP), 401k, flex spending accounts for medial and childcare needs, and participate in our tuition reimbursement and student loan repayment programs.

CLICK HERE to learn more about HCA's Comprehensive Benefits Package.

Intrigued? We'd love to hear from you!

"We are an equal opportunity employer and we value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status."


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Case Manager RN Case Management PRN

HCA