$10,000 SIGN ON BONUS!

Mackinac Straits Health System, located right across the mighty Mackinac Bridge, is searching for an RN Case Manager to join our team.

This position will provide ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. The goal of the position is to enhance the quality of: patient management and satisfaction, to promote continuity of care and cost effectiveness through the integrating of the functions of case management, utilization review and discharge planning. This position has accountability for the coordination of discharge planning of all inpatients. This position reports to the Nursing Executive for Acute Care.

SUMMARY Runs daily interdisciplinary care meetings and rounds with physicians Runs Comprehensive Community Care meetings to network with other local agencies Runs Utilization Review Committee (DNV requirement) Attend Transitions of Care meetings to improve facility policies and procedures Attends Community Focus group for networking of services, difficult patient/community concerns Weekly check in meetings with acute care executive Falls Champion- reviews all falls, completes fall audits, follow up education with staff and patients to prevent further falls and improve documentation Daily assessment of all patients and develops, monitors and evaluates patient treatment plans, facilitate interdisciplinary team (IDT) plans of care, and patient education plans. Reviews the overall care delivery process and follow up to ensure plans of care/treatment goals are being met and reports issues to Acute Care Director.

Assists with Advance Care Planning conversations with patients and families. Reviews history and physicals, daily progress notes in details and follows up with physicians for improved utilization of services Daily review of important message for Medicare (IMM) and Medicare outpatient observation notice (MOON) for compliance (DNV requirement) Daily analysis of admission data, including physician compliance/quality indicators, readmissions, extended stays, Interqual guidelines compliance, Medicare/Medicaid compliance, incomplete medical records and follows up with appropriate personnel to help facilitate improved processes Prepares comprehensive discharge planning- including evaluating discharge (DC) plans, arranging alternative DC placement, coordinating DC services, providing resources and education/training to patients and families Improves financial status through daily utilization review and recommending changes to policies, procedures, etc. Orders durable medical equipment (DME) Promote quality and cost-effective interventions and outcomes Review swing bed referrals and coordinate care to admit Daily insurance prior authorizations Daily insurance review Daily insurance re-certifications Write appeal letters for insurance denials Coordinate with physicians to improve insurance approval through peer to peer conversations with insurance companies Facilitate communications between care providers throughout multiple agencies and team members Help emergency room (ER) with triage and any assigned duties as available Help floor nurses with any patient care needs as available Responsible for all facility DC policies, swing bed policies, utilization review policies, fall risk assessment and interventions, interdisciplinary treatment plan and conference policies Ensure that all admission and DC policies and procedures are in compliance with CMS guidelines to ensure insurance reimbursement Monitors staff compliance with daily post-discharge follow up calls Assist patients in navigating the health care system- coordinating specialty care, follow up, and other care coordination needs Home health and hospice referral coordinator Coordinates with ER staff for discharge needs and resources for patients through ER

Additional Supervisory Duties Creation and review of policies Performs chart reviews Along with Nurse Executive and Nurse Educator, develops and carries out education plan for staff Acts as a provider/nurse liaison Assists with planning and implementation of quality projects Assists with development and implementation of clinical pathways

Qualifications:

• Registered nurse with Michigan licensure.
• Minimum of 3 years of Acute Care clinical practice experience required.
• Organization, prioritization, communication skills (verbal, interpersonal, and written),

customer relations and basic computer skills.

• Certification in case management preferred or obtained with in 3 years of hire.
• Demonstrated ability to work collaboratively within a multidisciplinary team.

Job Type: Full-time

Pay: $60,000.00 - $62,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Free parking
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Medical specialties:

• Critical & Intensive Care
• Medical-Surgical
• Primary Care

Schedule:

• Day shift
• Monday to Friday

Work setting:

• Hospital

Ability to commute/relocate:

• Saint Ignace, MI 49781: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Nursing: 1 year (Required)

License/Certification:

• RN (Required)

Work Location: One location

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