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Nurse Case Manager

companyKunkel & Associates
locationDubuque, IA, USA
PublishedPublished: 6/14/2022
Full Time

Job Description

Description:

The Nurse Case Manager plays a pivotal role in delivering continuous support and specialized knowledge by conducting thorough assessments and coordinating the care of individual patients. This includes implementing and evaluating personalized patient care plans and various KCS programs. The primary responsibility is to ensure high-quality patient care while optimizing healthcare resources. This is achieved through effective utilization review and comprehensive case management. Additionally, the role involves nurse advocacy and promoting wellness, contributing to the overall improvement of patient health outcomes and efficient use of healthcare services.

Requirements:

Responsibilities:

  • Facilitate program execution, including utilization and case management, nurse advocacy, and wellness initiatives.
  • Conduct medical necessity reviews for precertification requests.
  • Input data and manage information using our specialized internal software.
  • Build and maintain strong relationships with clients, patients, their families, and support staff.
  • Employ strategies in relationship management, service coordination, resource optimization, education, and patient advocacy to enhance care quality, cost-effectiveness, and optimal medical outcomes. This includes reducing hospital stay durations and ensuring care continuity.
  • Deliver patient-centered case management to enhance care quality and achieve cost savings.
  • Act as a patient advocate, helping patients understand their clinical status and treatment options.
  • Keep meticulous client records, including case notes, progress logs, necessary documentation, and communication.
  • Prepare and provide timely reports on cost projections for future needs and patient prognoses.
  • Conduct presentations on health and wellness topics to employees.
  • Compile and analyze statistical data for health plans and employer groups, focusing on engagement rates, success rates, return on investment, and annual reporting for participants in health program.
  • Assess patient satisfaction and the quality of care provided.
  • Perform additional duties as required.

Skills/Qualifications:

  • Associate or Bachelor's degree from an accredited nursing program.
  • At least two years of experience in utilization review/case management or five years of clinical nursing experience.
  • Current professional nursing license.
  • Case management certification is preferred.
  • Compliance with continuing education requirements.
  • Ability to manage mental and emotional stress associated with working with ill, disabled, elderly, or emotionally distressed individuals.
  • Proficient in working with diverse groups, demonstrating effective communication, organizational, and administrative skills.
  • Proficiency in Microsoft Outlook, Word, Excel, Prezi, and medical management software.
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