About Us
McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan and Indiana. The McLaren system includes 13 hospitals in Michigan, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, one of only 53 National Cancer Institute-designated comprehensive cancer centers in the U.S.
Case Manager Registered Nurse - Case Management
Department: Case Management
Shift: Days
Daily Work Times: 7:30 am - 4:00 pm
Scheduled Biweekly Hours: 80
Position Summary:
Is able to function in a collaborative process with patients, nurses, social workers, physicians, caregivers, and the community in a process that encompasses communication and facilitates care along a continuum through effective resource coordination. Performs work processes, which includes securing authorization/certification for inpatient services; accomplishes positive patient outcomes in accordance with quality monitoring including patient care protocols, evidence-based standards of care, and patient and family guidance. The working framework of the Case Manager consists of interaction, assessment, planning, implementation, and finally evaluation. Desired outcomes are continually monitored, reassessed, and revised, if needed to improve patient services. The collaborative effort with a multidisciplinary team will ensure that the care provided is safe, effective, efficient, client-centered, timely and equitable. Utilization of the Case Management process includes the achievement of optimal health, access to care and appropriate utilization of resources balanced with the patient's right to self-determination.
Essential Functions and Responsibilities:
1. Conducts Case Management admission and concurrent reviews to evaluate and determine medical necessity based on established criteria/authorizations/certifications; monitors LOS; confers with Manager/Director and other multidisciplinary team members as appropriate.
2. Develops and implements continuum of care needs based on daily reviews and assessments; organizes family meetings with physicians, conducts pre-admission assessments as necessary.
3. Monitors, discuss, and educate medical staff regarding the utilization of resources and setting along with appropriateness of services provided, deviation from quality care practices, utilization of resources, and cost of care.
Required:
· Current
· BSN or Bachelor degree in health related field or completion within three years of accepting position. Two years of CM related experience in place of having a bachelor’s degree.
· BLS certification
· Three years of acute care nursing experience with two years CCU, ICU or experience in a clinically similar unit if staffing for a critical care position.
· Flexibility of hours/days to meet needs of patients, families and organization.
Preferred:
- National certification.
- Nursing skill mix equivalent to setting.
- Utilization review experience
- Master of Science Nursing or Clinical Nurse Specialist.
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans
We are committed to encouraging and sustaining a work environment free of unlawful harassment, discrimination, and/or retaliation. We are an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual’s race, color, age, religion, sex/pregnancy (including pregnancy/childbirth or pregnancy/childbirth-related conditions), sexual orientation, gender identity, national origin, disability, veteran status, genetic information, or any other status prohibited by applicable laws. We also make good faith efforts to recruit, hire, and promote qualified women, minorities, individuals with disabilities, and veterans.
Equal Opportunity Employer
McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.
