| || Timely and accurate assessment of the patient clinical, social, functional and continuing care needs through direct observation, data analysis and interviews in order to evaluate the need for intervention. Responsible for patient care planning from pre-operative phase through acute care discharge. Identifies and plans for pre-operative, acute care and discharge needs for patient. Sets appropriate patient goals and time frames. Implements plans as appropriate to attain desired outcomes within projected time frames. Incorporates evidence based standards and guidelines to continuously improve practice and to enhance patient outcomes. Evaluates and measures patient response to planning, services and intervention in order to assure quality of services and to make improvement where necessary|
| || 2 years of RN or Clinical Case Manager experience. Strong clinical skills and working knowledge of Clinical Pathways in the area assigned.
Experience in the nursing process. General knowledge of case management process including utilization review, transitional planning, outcomes management and assessment. General knowledge of payer industry, resource management, and evidence based clinical practice is essential. Bachelors degree in nursing. Introduction of case management process
& knowledge of Regulatory Readiness. Strong analytical, data management and PC skills. Experience and application in case management process and knowledge of regulatory requirement preferred. Experience in the acute care case management process - current working knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement preferred. Current RN license in state of Virginia or compact license. Advanced communication and interpersonal skills with all levels of internal and external customers including but not limited to medical staff, patients and families, clinical personnel, support and technical staff, outside agencies, and members of the community. Other skills needed include excellent written/verbal communication skills, critical thinking, creative problem solving, proficient organization and planning. Must be self-directed with ability to tolerate frequent interruptions and a demanding workload