U

University of Mississippi Medical Center

Academic medical center

RN Case Manager

Full-TimeUpdated
No salary listed
Junior
Jackson, MS, USA
In Person
Medical, Clinical & Veterinary

About the job

Requirements
  • Must hold a valid Mississippi registered nurse license, a compact-state license, or be eligible to transfer a registered nurse license to Mississippi.
  • Must have at least one year of acute care experience.
  • Must think critically and prioritize patient clinical needs effectively for transition into post-acute care.
  • Must be able to take initiative, work independently, solve problems, and meet goals and timeframes.
  • Must center services around patients’ clinical needs, foster patient self-management, and maximize efficient and cost-effective use of health resources.
  • Must advocate for patients, payers, and the healthcare organization to support continuity of care and quality patient outcomes.
  • Must comply with behavioral and ethical standards in accordance with the UMC nursing model, state Board of Nursing, and departmental policies and practices.
  • Must provide timely customer service to patients, families, payers, staff, physicians, community resources, and students; respond to assistance referrals; liaise with internal departments and external agencies to ensure continuity of care transitions; and maintain current information and documentation about services and eligibility criteria at federal, state, and local levels.
  • Must maintain an active registered nurse license and current knowledge of third-party payer and external regulatory-body standards, expectations, and Medicare Conditions of Participation related to discharge planning and care coordination.
Responsibilities
  • Coordinate a multiprofessional plan of care addressing general and clinical discharge needs and anticipating clinical needs that support individual patient health maintenance.
  • Conduct comprehensive assessments of clinical discharge needs using nursing processes and best or evidence-based practice.
  • Coordinate care and services, identify cases, conduct follow-up assessments and screenings, determine eligibility, and develop monitoring schedules and evaluations related to discharge planning; use critical thinking, clinical judgment, and best or evidence-based practice to achieve optimal outcomes.
  • Round with attending physicians and resident or mid-level provider staff to identify discharge needs and provide clinically based, patient-centered recommendations.
  • Maintain active communications and timely medical-record documentation with the care team to support appropriate patient management; address or resolve system problems impeding diagnostic or treatment progress; identify and resolve discharge delays and obstacles; use conflict-resolution skills as needed; collaborate on designated caseloads, monitor patient progress, adjust discharge planning, and work with outside vendors as needed.
  • Organize and facilitate access to tests, procedures, and diagnostic results to maintain or reduce general length of stay.
  • Resolve daily issues using clinical nursing knowledge and expertise to support patient transitions, seek supervision when appropriate, and regularly present case scenarios to supervisors to demonstrate clinical competencies and care-transition knowledge and skills.
  • Participate in employee council as requested and research best and evidence-based practices that support safe patient and family outcomes and financial sustainability for third-party payers and UMC.
  • Identify opportunities to manage patients’ social determinants of health and work with social workers to mitigate readmission risk and poor health outcomes.
  • Participate in collecting, analyzing, and reporting departmental measures, including avoidable days and utilization-review elements.
  • Manage patient flow and safety to support appropriate throughput and organizational financial wellbeing.
  • Drive appropriate policy and practice changes through research, knowledge, and skills.
  • Arrange services within specified timeframes while maintaining a holistic nursing focus based on the UMC nursing care model, including skilled nursing facilities, long-term care, inpatient physical rehabilitation facilities, long-term acute hospitals, group homes, home health care, home infusion, enteral feedings, home ventilators, wound-vac, ostomy supplies, and tracheostomy supplies; perform additional activities within scope of practice.
  • Participate in departmental resource management and coverage to maintain adequate staffing and consultation availability for patients, designees, and families; attend at least 50% of monthly staff meetings in a fiscal year; reduce duplication and unnecessary services; determine appropriate use of hospital funds or supplies; investigate and help patients and families secure financial and clinical resources to ensure continuity of care; and coordinate with social workers and financial counselors as needed.
  • Support appropriate patient transitions with urgency through teamwork, accountability, innovation, respect, ethical behavior, and emotional intelligence.
Desired Qualifications
  • Utilization-management or previous case-management experience is preferred.
  • Accredited Case Manager Certification or Certified Case Manager certification is preferred but not required.

About the company

U

University of Mississippi Medical Center

View

University of Mississippi Medical Center is Mississippi’s public academic medical center and health-sciences university. The institution operates hospitals, clinics, professional schools, research programs, and statewide health initiatives. It serves patients, students, families, clinicians, researchers, and communities throughout Mississippi. Its operating model centers on clinical care integrated with education, research, public service, and centralized university operations. Teams work across nursing, physicians, allied health, research, education, technology, facilities, and administration. Work depends on coordination among clinical, operational, technical, and support teams across its care settings and communities.

Company Size

N/A

Company Stage

N/A

Total Funding

N/A

Headquarters

N/A

Founded

N/A