In collaboration with the patient/family, social workers, physicians and interdisciplinary team, the RN case manager ensures patient progression through the continuum of care in an efficient and cost effective manner. The RN case manager is responsible for identifying, initiating and managing optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety and length of stay management. Support and expertise are provided through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. Care coordination, utilization review and management, as well as discharge planning are accountabilities of this role. Education is provided to physicians and other members of the team on the issues related to utilization review including inappropriate admissions and placements. Payer-based requests regarding individual members are fulfilled, where appropriate and pertinent. The Case Manager adheres to departmental and organizational goals, objectives, standards of performance and policies and procedures, continually assuring quality patient care and regulatory compliance.
EDUCATION: Graduate of an accredited school of nursing, BSN preferred OR Masters Degree in Social Work (MSW) required
CERTIFICATION/LICENSES: Licensed to practice independently and formulate diagnoses in the State of New Mexico as a LMSW, LISW or LCSW. OR Licensed as a Registered Nurse to practice nursing in the state of New Mexico. Meets contact hour requirements for licensure, including all state required courses. Completion of prevention and management of aggressive behavior course within 2 months. BLS within 6 months.
Ability to work independently on own accord and initiative, yet as a team member
Strong communication and interpersonal skills
Advanced behavioral health assessment and referral skills
Understanding of complex psychopathology and ability to deal with all types of patients with myriad behavioral health conditions
Understanding of crisis intervention theory, case management, and referral process; knowledge of psychopathology and ICD-10 diagnoses
Ability to negotiate with community providers and third party insurers
Strong clinical and interpersonal skills
Ability to lead and co-lead cognitive behavioral, psychoeducational, DBT and supportive therapy sessions
Understanding of recovery process
Formulates treatment plans in conjunction with rest of treatment team
Ability to assess clients in an emergency situation and initiate transfer to higher level of care when needed.
Flexibility with job assignments
Ability to read, write and communicate verbally in English.
EXPERIENCE: Minimum two years clinical experience in a behavioral health or related setting is this required or preferred?. Experience working in a primary care setting is preferred.
NATURE OF SUPERVISION: -
Responsible to: Director or designee, BHS
- Bloodborne pathogen B
Multiple simultaneous activities around patient care. Exposure to infectious diseases and intermittent exposure possible to blood, excrements, odors and noise. Work area has normal heat, light, and air.
PHYSICAL REQUIREMENTS: Emotional and physical ability to cope with stress and physical nature of inpatient work with behavioral health patients; possibility of emergency lifting and need for physical interventions. Must be able to handle emergency/crisis situations, prolonged, extensive or considerable standing/walking. Has knowledge of and uses good body mechanics. Frequently lifts, positions, pushes and/or transfers patients or equipment. Ability to work in crisis and potentially hazardous situation(s). Hearing and visual acuity within normal limits. Manual dexterity and fine motor coordination required. Is scheduled to be on-call, and expected to work on short notice and on an emergency basis.
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.