Registered Nurse Case Manager

Locations: Ganado, AZ Type:Tribal Salary Range:Salary Negotiable Open Period:1/1/2023 until filled Summary:Affordable Health Insurance, 403B Pension Plan, Traditional Healing Reimbursement, Short Term Disability, Long Term Disability, Life Insurance, AD&D, Employee Assistance Program, Employee Recognition Program, PTO & Paid Holiday with (2) Floating Holidays, Wellness Center Membership, Child Care Services, Onsite Housing for eligible positions, and Loan Repayment Program More info about area: Job Announcement Flyer: Duties:
• Coordinate continuing care services to include utilization review, management, and discharge planning activities.
• Review admission data on patients to establish appropriateness of the admission using InterQual criteria.
• Coordinate continuing care and utilization review of Medical/Telemetry Unit, Emergency Department, and other clinical areas upon request.
• Conduct concurrent reviews to determine the continued need for acute care setting, appropriateness, and timeliness of treatments/procedures to optimize the potential for reimbursement.
• Identify and coordinate continuing care needs or potential home care recipients through assessment, interdisciplinary care rounds and/or requests.
• Establish coordinated discharge plans based on the patient's assessed needs, available family support, available community services, and the patient/family's choice.
• Review incoming Swing Bed requests and coordinate with corresponding disciplines like rehabilitation services, wound care nurse, and Medical Doctor if the patient is a good candidate for our Swing Bed program. RN should be able to provide feedback to the referring facility within 12-24 hours
• Interface with external reviewing agencies and/or Case Managers regarding medical necessity, appropriateness of care, ongoing treatment plan and post-hospital discharge plan to ensure patient needs are met.
• Meet and comply with hospital policies and procedures.
• Maintain compliance with applicable laws, regulations, and ordinances including The Arizona Department of Health Division of Licensing Services (AzDH), Centers for Medicare/Medicaid Services (CMS) and The Joint Commission.
• Complete required competencies for each unit assigned to work and hospital mandatory trainings each year.
• Provide Case Management coverage for Medical/Telemetry Unit, Swingbed Referral Request, Emergency Department, Outpatient Clinic, Diabetes Program, and the Community Health Nursing Department.
• Assess, establish, implement, and communicate goals, objectives, policies, and procedures in accordance with nursing plan and practice.
• Initiate multidisciplinary collaboration, including patient, family, caretaker, and healthcare team, to ensure proper provision of patient care to meet assessed needs for psychological, psychosocial, environmental, educational, and discharge planning.
• Provide consistent and continuous case consultation with service providers.
• Please see Job Description for additional duties. Qualifications:Minimum Qualifications:
• Bachelor's Degree in Nursing with experience in case management.
• If ADN, must be concurrently enrolled in an accredited nursing program pursuing a Bachelor Degree or Master Degree in Nursing with two (2) years of Case Management experience. Must present enrollment documentation to the Nursing program, proof of attendance, and anticipated date of graduation.
• Valid and unrestricted nursing license from the State of Arizona or compact licensing state.
• Valid American Heart Association Healthcare Providers BLS certification.
• Must obtain a valid American Heart Association Healthcare Providers ACLS certification within 90 days of hire.
• Must be able to successfully pass the Employee Health Program requirements and background investigation. Work Type:Permanent, Full Announcement :NUR-23-00006