• RN - Case Manager

    Good Samaritan Society - International Falls
    Job Description
     

    This position provides care to assigned residents in a caring, safe and efficient manner and is responsible to perform the following according to location standards, procedures and individualized resident care plans.


     

    Receives referrals, conducts analysis of resident’s needs, ensures appropriateness of admission according to payer source and quality care; oversees fiscal management of the payer revenue/expenses from admission through discharge. Assures residents, families and / or significant others are aware of current payment system requirements and guidelines. Provides residents with opportunities for independence and choice consistent with their care plans. Directs and assists with staff resident, family/significant other education regarding payer system issues. Serves as vital link to all Medicare team members and other disciplines to ensure delivery of resident benefits under the specific payer plan. Stays updated on current payment issues, interpretations and RAI/MDS updates; receives and shares information. Establishes appropriate payer system documentation guidelines. Directs and documents care provided to residents. Functions as the main contact between payer and resident and family; communicates regular updates on resident progress and outcomes. Participates in Admission-Transfer Discharge Team. Uses the EMR accurately.

    Basic Responsibilities:
    This position will be held accountable for complying with all related laws, regulations, company policies and procedures pertaining to his or her position and for fulfilling his or her obligations under the Society's Corporate Compliance Program.
    Other Duties:
    Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
     
    Education Experience Licensure Certification:

    (Nursing (RN) and medical) knowledge required; graduate of an accredited school of nursing. licensure, registration or certification for state of practice is required; case management certification desirable; a Master Social Worker (MSW) with previous managed care case management and medical social work experience may meet the qualifications.

    Skills/Abilities:

    Ability to perform critical analysis of clinical issues to extrapolate necessary data and information to develop accurate costing and effective critical pathways / care planning to ensure quality resident outcomes.

    Knowledge:

    Basic ability to communicate and comprehend; ability to measure and comprehend certain quantities; knowledge of health care payer systems including managed care and Medicare eligibility and coverage requirements; knowledge and familiarity with the therapeutic effects and side effects of all medications administered; sound clinical (Nursing (RN) and medical) knowledge required.

    Physical/Mental Requirements: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee will operate/activate/use/prepare/inspect/place/detect/position objects, tools, or controls. The employee will frequently communicate/express oneself/exchange/observe/assess/detect information relative to this position. The employee is required to maintain a stationary position/move/position self in response to job tasks. Must be able to effectively communicate in English, both orally and in writing.
    Supervisory Responsibilities: Directly supervises assigned employee(s). Carries out supervisory responsibilities in accordance with the organization's policies, procedures and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems; fostering an environment for employee engagement.
    Accommodations: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
    Work Environment: The noise level in the work environment is usually moderate. Frequency of travel may vary based on business need.
    Weight Lifting Requirement: 20  lbs.
    Contact Information

  • International Falls Workforce Center 
    Rainy River Community College 
    1501 Highway 71, SC 128 
    International Falls, MN 56649-2160 

    Telephone and Email 
    1-218-283-9427 Or intlfalls.wfc@state.mn.us

    Hours of Operation 
    8AM to 4:30PM 
    Monday-Friday 

    Additional Job Source Resources:

    https://www.minnesotaworks.net/
    http://mn.gov/deed/business/ 
    http://www.ifallsjournal.com/classifieds/job/