Everyone who works with Mercy Health is united under one purpose: to help our patients be well in mind, body and spirit. This drive, along with our history of faith, is a powerful combination. It gives us a shared calling to work toward every day. Join our exceptional team and help us continue to provide the highest quality of health care possible to our communities.

Primary Function/General Purpose of Position

The RN Case Manager coordinates the care and services of selected patient populations across the continuum of illness; promotes effective utilization and monitoring of health care resources; and leadership role with the interdisciplinary team to achieve optimal clinical, resource and quality outcomes.

Essential Job Functions

• Accurately identifies patients who meet the guidelines for case management. Develops, implements, monitors and modifies the plan of care for the patient through a collaborative and interdisciplinary team process. Assesses the patient's physical, psychological, functional, social, environmental, and financial status and goals. Utilizes the data collected in the assessment process to formulate and document interdisciplinary outcomes (goals) to be achieved. Continually assess outcomes and goals for workability, manageability, cost effectiveness, and updates the plan as needed. Maintains patient confidentiality and is knowledgeable of the HIPAA guidelines for patient confidentiality. Actively participates in Quality flow rounds. Assists direct care staff in establishing daily goals and monitors the progress in meeting these goals.
• Locates community resources and links the patient to the most appropriate ones. Evaluates the patients' s formal and informal support systems. Assesses family/caregiver coping styles, and the ability of the family/caregiver to support and participate in the planning of care. Acts as a leader and a liaison among the disciplines. Facilitates communication with all providers of care, and facilitates access to care. Assumes responsibility for cost effectiveness.
• Analyze information required to make clinical and business decisions. Translate data into meaningful information.
• Evaluates professional activities to assure that the planned services are being delivered and that they meet the stated outcomes/goals. Monitors the patient's progress towards outcomes and makes recommendations as to the continuation of services. Is knowledgeable of disease processes, treatment protocols, and pharmacological management to assure appropriate care delivery.
• Understands payer principles, terminology of managed care, and the goals of the managed care Industry. Assures that the hospital is able to provide the necessary care needed to meet the physical/medical needs of the patient. Maintains knowledge of community services and agencies. Advocates for the patient and/or hospital as appropriate when dealing with insurance companies/third party payers.
• Is knowledgeable of Length of Stay and Case Mix Index and ways of improving. Is accurate, consistent and concurrent in documenting insurance and other data elements in the appropriate case management computer tools. Understands the knowledge and principles of the hospital DRG assurance program.
• Demonstrates technical proficiency and seen as an expert within assigned clinical and business function.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Qualifications

Required Minimum Education:
Associates Degree
Specialty/Major: Nursing

Preferred Education:

Bachelor of Science in Nursing (BSN) or Graduate Degree (Masters)
Specialty/Major: Nursing, Healthcare

Licensure/Certification:
RN License in the state of work (OH) (required)

Case Management Certification (ACM, CCM, or ANCC) (preferred)

Minimum Years and Type of Experience:
5 years experience as an RN in a hospital and/or clinic setting; basic CPR

Other Knowledge, Skills and Abilities Required:
EPIC Electronic Medical Record; Board fairly detailed knowledge of InterQual and MCG criteria.

Other

Patient Population - Mark selections with an "X":

The following must be included in all position descriptions that involve direct or indirect patient care. This is a Joint Commission requirement. Also, select the age of the patient population served:

x Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.

x Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.

x Neonates (0-4 weeks)

x Infant (1-12 months)

x Pediatrics (1-12 years)

x Adolescents (13-17 years)

x Adults (18-64 years)

x Geriatrics (65 years and older)

Not applicable to this position

Working Conditions - Mark selections with an "X":

This section addresses the physical environment in which the employee will perform the work. Please identify ALL working conditions that apply to the role.

x Periods of high stress and fluctuating workloads may occur.

x Long-distance or air travel as needed- not to exceed 10% travel.

x General office environment.

x May be exposed to high noise levels and bright lights.

x May be exposed to physical altercations and verbal abuse.

x May be exposed to limited hazardous substances or body fluids.*

May be required to use physical restraints.

x May be exposed to human blood and other potentially infectious materials.*

May be exposed to adverse weather conditions; cold, hot, dust, wind, etc.

x May have periods of constant interruptions.

x Required to car travel to off-site locations, occasionally in adverse weather conditions.

x Prolonged periods of working alone.

____ Other:

____ Not applicable to this position

• Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.

Physical Requirements - Mark selections with an "X":

This section addresses the physical demands and work position of the associate in the role. Please identify the frequencies for ALL physical requirements for each physical demand and work position below.

Physical Demands

Frequency 0% 1-33% 34-66% 67-100%

Lifting/ Carrying (0-50 lbs.) x

Lifting/ Carrying (50-100 lbs.) x

Push/ Pull (0-50 lbs.) x

Push/ Pull (50-100 lbs.) x

Stoop, Kneel x

Crawling x

Climbing x

Balance x

Bending x

Work Position

Frequency 0% 1-33% 34-66% 67-100%

Sitting x

Walking x

Standing x

Additional Physical Requirements/Hazards - Mark selections with an "X":

This section addresses the additional physical requirements/hazards on the associate in the role. Please identify ALL additional physical requirements/hazards.

Physical Requirements - Select if a physical requirement for this job.

x Manual dexterity (eye/hand coordination)

x Perform shift work

Maneuver weight of patients

x Hear alarms/telephone/audio recordings

x Reach above shoulder

x Repetitive arm/hand movements

x Finger Dexterity

x Color Vision

x Acuity – far

x Acuity – near

____ Not applicable to this position

Hazards - Select if a potential hazard for this job.

x Depth perception

x Use of Latex products

x Exposure to toxic/caustic/chemicals/detergents

x Exposure to moving mechanical parts

x Exposure to dust/fumes

x Exposure to potential electrical shock

x Exposure to x ray/electromagnetic energy

x Exposure to high pitched noises

x Gaseous risk exposure

Other:

____ Not applicable to this position

Many of our opportunities reward* your hard work with:

Comprehensive, affordable medical, dental and vision plans
Prescription drug coverage
Flexible spending accounts
Life insurance w/AD&D
Employer contributions to retirement savings plan when eligible
Paid time off
Educational Assistance
And much more

• Benefits offerings vary according to employment status

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com