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RESPONSIBILITIES:

• Develops, implements and maintains a system of outcome management. Ensures coordination of care across the continuum on a financial platform.

REQUIREMENTS:

Education/Experience:

• Graduation from an accredited school of nursing and five (5) years of clinical nursing experience, two (2) years of which were in a supervisory/managerial role.

Licensing/Certification Requirements:

• License from State of Nevada to Practice as a Registered Nurse. Basic Life Support (BLS) certification accepted by the American Heart Association (AHA).

Additional Position Requirements – PREFERENCES WILL BE GIVEN TO APPLICANTS WHO DOCUMENT THE FOLLOWING:

• Bachelor’s degree in nursing.
• Minimum fifteen (15) years of experience in Nursing.
• Minimum ten (10) years of experience in Case Management.
• Minimum five (5) years of recent experience in a leadership role in Case Management.
• Recent documented experience in an Acute Care setting.

One or more of the following A PLUS!

• Certified Case Manager (CCM) or Accredited Case Manager (ACM).

Membership in:

• The Commission of Case Management Certification (CCMC).
• Academy of Certified Case Managers (ACCM).
• American Case Management Association (ACMA).

Knowledge of:

Care Management principle related to eligibility, authorizations, admission assessment, concurrent/retro-eligible review, denials and appeal; interqual and basic understanding of Milliman Care guidelines; supervisory principles and practices; nursing process (assessment, planning, implementation and coordination of patient care); standards of care; disease process of illnesses or injuries in variety of specialty areas; patient care plan development; patient evaluation and assessment techniques; Nurse Practice Act; third party reimbursement regulations and rules; department and hospital safety practices and procedures; patient rights; infection control policies and practices; handling, storage, use and disposal of hazardous materials; department and hospital emergency response policies and procedures; age specific patient care practices.

Skill in:

Working with patients in a variety of conditions; supervising the work of assigned staff; interpreting rules and regulations; interpreting and analyzing patient medical charts for acute care criteria; using computers and a variety of software applications; communicating with a wide variety of people from diverse socio-economic and ethnic backgrounds under stressful conditions; establishing and maintaining effective working relationships with all personnel contacted in the course of duties; efficient, effective and safe use of equipment.

Physical Requirements and Working Conditions:

Mobility to work in a typical clinical setting, including stamina to remain standing and/or walking for extended periods of time, strength to examine and treat varied individuals, vision to use standard office equipment, read printed materials and a VDT screen, and hearing and speech to communicate effectively in-person and over the telephone. Strength and agility to exert up to 10 pounds of force occasionally and/or an eligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this classification.