Case Manager Nurse

Ruby Memorial Hospital (wvuh)mid

Case ManagerHealthcare Clinical

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Quick Summary

Key Responsibilities

The statements described here are intended to describe the general nature of work being performed by people assigned to this position.

Requirements Summary

EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1.

Technical Tools

Case ManagerHealthcare Clinical

About the Role

~1 min read

This position comprehensively plans for targeted patient populations. Performs resource management, including denial management, utilization management, access to the appropriate level of care, discharge planning, care facilitation, and referral to other levels of care. Works collaboratively with the multidisciplinary care team to facilitate achievement of desired treatment outcomes.

Requirements

~1 min read

1. Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC).

1. Bachelor’s degree in Nursing (BSN)

1. Three (3) years clinical experience.

Responsibilities

~1 min read

1. Knowledge of patient’s current medical insurance coverage and limitations and the precertification requirements for Durable Medical Equipment (DME), post-acute placements, infusions, transfers etc

2. Knowledge of relevant scientific principles, established standards of care and/or research findings.

3. Knowledge of procedures and techniques involved in administering routine and special treatments to patients.

4. Knowledge of and appropriate application of the nursing process.

United States of America (Exempt)

403 WVUH Care Management

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.