Nurse Case Manager

Job Description Summary

The Nurse Case Manager reports to the Manager/Director of Case Management. Under general supervision, the primary function of the position is to organize services across provider lines, between people and systems, to affect optimal patient outcomes, achieve continuity and quality of care and reduce cost. The Case Manager is responsible for the development, planning, coordination, and administration of functions including activities such as Utilization Review, Discharge Planning, Social Services, and Resource Management including daily review of medical records to determine appropriateness and medical necessity of admissions, continued hospital stay, and use of ancillary services.

Entity

Medical University Hospital Authority (MUHA)

Worker Type

Employee

Worker Sub-Type​

Regular

Cost Center

CC003747 COL - Case Management (DMC)

Pay Rate Type

Salary

Pay Grade

Health-28

Scheduled Weekly Hours

40

Work Shift

Day (United States of America)

Job Description

Entity/Organization:  MUHA (Medical University Hospital Authority/Medical Center)

Hours per week: 40

Scheduled Work Hours/Shift: M-F, 8:00 am – 5:00 pm

Fair Labor Standards Act Status: Salaried

Job Summary/Purpose: The Nurse Case Manager reports to the Manager/Director of Case Management. Under general supervision, the primary function of the position is to organize services across provider lines, between people and systems, to affect optimal patient outcomes, achieve continuity and quality of care and reduce cost. The Case Manager is responsible for the development, planning, coordination, and administration of functions including activities such as Utilization Review, Discharge Planning, Social Services, and Resource Management including daily review of medical records to determine appropriateness and medical necessity of admissions, continued hospital stay, and use of ancillary services.

Provides nursing care to patients using the nursing process (assessment, planning, implementation, and evaluation). Directs and leads other assigned team members and collaborates with multidisciplinary team members to provide age/developmentally appropriate care in accordance with nursing standards of care and practice. Provide patient/family centered care using the nursing process and focusing on the physical, emotional, spiritual, cultural, religious, and environmental needs. This includes providing for the assessment, development of nursing diagnoses, outcome identification, planning, implementation of interventions, coordination of care, health teaching and promotion and evaluation of goals and interventions consistent with the policies of MUSC.

Maintains a safe, therapeutic, and healing environment through ensuring patient privacy and responsive, respectful, accepting, and professional behavior. Demonstrates the ability to function in a professional setting through active participation in a professional practice model. This includes participating in shared governance, adherence to standards of care, participation in peer review and professional development promoting leadership and clinical excellence, effective team skills, autonomous practice and acknowledgment of accountability for actions and critical thinking. Coordinates the effective and efficient delivery of patient care services through the application of care management principles. Identifies clinical priorities and initiates action to improve patient outcomes. Demonstrates ability to function in a professional practice model through active participation in shared governance, promotion of a healthy work environment and acceptance of personal responsibility for professional growth.

Minimum Training and Education:  Three years work experience as a Registered Nurse required. Two years of case management and/or utilization review work experience preferred.

Required Licensure, Certifications, Registrations:  Associate’s Degree in Nursing. Bachelor’s Degree in Nursing preferred.  

Case Management certification preferred.

Current Basic Life Support (BLS) or ACLS required from the American Heart Association (AHA).

Additional Duties and Responsibilities:

Physical Requirements: Ability to perform job functions while standing. (Continuous) Ability to perform job functions while sitting. (Continuous) Ability to perform job functions while walking. (Continuous) Ability to climb stairs. (Infrequent) Ability to work indoors. (Continuous) Ability to work outside in temperature extremes. (Infrequent) Ability to work from elevated areas. (Frequent) Ability to work in confined/cramped spaces. (Frequent) Ability to perform job functions from kneeling positions. (Infrequent) Ability to bend at the waist. (Continuous) Ability to twist at the waist. (Frequent) Ability to squat and perform job functions. (Frequent) Ability to perform “pinching” operations. (Frequent) Ability to perform gross motor activities with fingers and hands. (Continuous) Ability to perform firm grasping with fingers and hands. (Continuous) Ability to perform fine manipulation with fingers and hands. (Continuous) Ability to reach overhead. (Frequent) Ability to perform repetitive motions with hands/wrists/elbows and shoulders. (Continuous) Ability to fully use both legs. (Continuous) Ability to use lower extremities for balance and coordination. (Frequent) Ability to reach in all directions. (Continuous) Ability to lift and carry 50 lbs. unassisted. (Infrequent) Ability to lift/lower objects 50 lbs. from/to floor from/to 36 inches unassisted. (Infrequent) Ability to lift from 36" to overhead 25 lbs. (Infrequent) Ability to exert up to 50 lbs. of force. (Frequent) Examples include: To transfer a 100 lb. patient that can not assist in the transfer requires 50 lbs. of force. For every 100 additional pounds, assistance will be required from another healthcare worker. 20 lbs. of force is needed to push a 400 lb. patient in a wheelchair on carpet. 25 lbs. of force is required to push a stretcher with a patient with one hand. Ability to maintain 20/40 vision, corrected, in one eye or with both eyes. (Continuous) Ability to see and recognize objects close at hand or at a distance. (Continuous) Ability to match or discriminate between colors. (Continuous) Ability to determine distance/relationship between objects; depth perception. (Continuous) Good peripheral vision capabilities. (Continuous) Ability to maintain hearing acuity, with correction. (Continuous) Ability to perform gross motor functions with frequent fine motor movements. (Continuous) Ability to deal effectively with stressful situations. (Continuous) Ability to work rotating shifts. (Frequent) Ability to work overtime as required. (Frequent) Ability to work in a latex safe environment. (Continuous) Ability to maintain tactile sensory functions. (Continuous) (Selected Positions) *Ability to maintain good olfactory sensory function. (Continuous) *(Selected Positions) *Ability to be qualified physically for respirator use, initially and as required. (Continuous) (Selected Positions)

Additional Job Description

Minimum Training and Education:  Three years work experience as a Registered Nurse required. Two years of case management and/or utilization review work experience preferred.

Required Licensure, Certifications, Registrations:  Associate’s Degree in Nursing. Bachelor’s Degree in Nursing preferred.  

Case Management certification preferred.

Current Basic Life Support (BLS) or ACLS required from the American Heart Association (AHA).

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

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