Pediatric Lead RN Case Manager Days FT Children's Hospital of Michigan

Under limited direction and according to established policies and procedures, provides clinical group leadership and expert technical guidance to the case management/care coordination staff in assigned department.. Promotes consistent application, effective processes and clinical service accountability for the case management/care coordination program process. Assists in the development and implementation of policies and procedures related to the Case Management process. Assists with monitoring performance standards, productivity and ensuring staff coverage to meet the needs of the department. Provides support for catastrophic cases within the clinical service group. Assists with controlling staffing levels to meet budgetary guidelines; trains, evaluates, disciplines and discharges subordinate staff, in collaboration with department manager/director. Performs the duties of subordinate RN staff by assessing, developing, implementing and monitoring a complete plan of care through the interdisciplinary team process in conjunction with patient and family in an internal setting. On a concurrent basis, assesses level of care, diagnostic testing and procedures performed, quality and clinical risk issues, and documentation for medical record completeness. Communicates with patient, family, medical team, caregivers and third party payors as necessary. Formulates, implements and evaluates educational strategies for staff, patient and family. Analyzes case management/care coordination outcomes to identify issues and make recommendations. Engages physician advisor to facilitate care decisions, as needed. Maintains current knowledge of health care techniques/practices, and care management strategies through educational programs/resources. Maintains a working knowledge of the requirements of payers, regulatory and compliance entities. Establishes and maintains effective relationships with physicians and all other staff members, internally and externally. Identifies problems or any dissatisfaction experienced by any customer or referring source and works to resolve them to a high degree of service excellence. Uses positive interpersonal skills to effectively resolve conflict. Promotes a positive customer relations environment. Performs other duties and functions as assigned.

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1. Graduate from an accredited school of Nursing. Bachelor's degree in Nursing or other health-related field, or equivalent combination of education and/or related experience. Master's degree preferred.

2. Three to five years clinical nursing experience.

3. Two years of experience in Discharge Planning, Utilization Review or Case Management.

4. One to two years of supervisory/management experience preferred.

5. License to practice as a Registered Nurse in the State of Michigan.

6. Case management certification strongly preferred.

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