Henry Ford Health System Registered Nurse (RN) Case Manager I / Wyandotte (Contingent) in Wyandotte, Michigan
GENERAL SUMMARY: The purpose of the Case Manager I position is to support the physician and interdisciplinary team in facilitating patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payors. The role integrates and coordinates utilization management, patient education, care facilitation, and discharge planning functions. The Case Manager I is accountable for a designated patient caseload and plans effectively in order to meet patient needs, manage the length of stay, and promote efficient utilization of resources. Specific functions within this role include: Facilitation of precertification and payor authorization processes. Facilitation of the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement. Application of process improvement methodologies in evaluating outcomes of care. Support and coaching of clinical documentation efforts and serving as a clinical resource for coders ensuring that documentation accurately reflects severity of illness and intensity of service. Coordinating communication with physicians. Ability to demonstrate knowledge and skills necessary to provide care appropriate to the patient served. Ability to demonstrate knowledge of the principles of growth and development as it relates to the different life cycles.
EDUCATION/EXPERIENCE REQUIRED:Bachelors of Science in Nursing, required.Minimum of three years RN clinical experience, preferred. Possess interpersonal communication and negotiation skills. Possess analytical, data management and PC skills.Current working knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement, preferred.Organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components with minimal supervision.Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families.Performs duties in a manner to promote quality patient care and customer satisfaction, while promoting safety, cost efficiency, and a commitment to Continuous Quality Improvement process. CERTIFICATIONS/LICENSURES REQUIRED:Current and valid license to practice as a Registered Nurse in the State of Michigan.Overview Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health care systems, is a national leader in clinical care, research and education. The system includes the 1,200-member Henry Ford Medical Group, five hospitals, Health Alliance Plan (a health insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory network and many other health-related entities throughout southeast Michigan, providing a full continuum of care. In 2015, Henry Ford provided $299 million in uncompensated care. The health system also is a major economic driver in Michigan and employs more than 24,600 employees. Henry Ford is a 2011Malcolm Baldrige National Quality Award recipient. The health system is led by President and CEO Wright Lassiter III. To learn more, visitHenryFord.com. Benefits Whether it's offering a new medical option, helping you make healthier lifestyle choices or making the employee enrollment selection experience easier, it's all about choice. Henry Ford Health System has a new approach for its employee benefits program - My Choice Rewards. My Choice Rewards is a program as diverse as the people it serves. There are dozens of options for all of our employees including compensation, benefits, work/life balance and learning - options that enhance your career and add value to your personal life. As an employee you are provided access to Retirement Programs, an Employee Assistance Program (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other benefits and services. Equal Employment Opportunity/Affirmative Action Employer Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.