The Job: Under general supervision is responsible for ongoing development, implementation, and evaluation of processes of the CWHS Case Management Plan. The Case Management function is a highly collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client’s/patient’s health and human services needs. The RN Case Manager provides advocacy, communication, collaboration, resource management, and education to interdisciplinary team members of CWHS. Responsible for conducting admission and concurrent review of patients, assessing appropriate level of care and medical necessity, assessing patient discharge needs and provision of services necessary to facilitate a safe and timely discharge. Effective allocation of the hospital’s resources while encouraging provision of high quality patient care is essential in this role. Is cognizant of regulations and policies of all review organizations relating to billing of the fiscal intermediaries and implements processes and changes to meet the Federal/State regulations and CMS Conditions of Participation.
Work Schedule: Full Time
Location: Community Hospital
Maintain and improve the case management system using ongoing interaction with patients, physicians, and other health providers to meet designated clinical, operational, and financial outcomes for aggregate patient populations.
Assist physicians, patients, families, staff and payers in providing care for patient populations that is appropriate, effective, and cost efficient.
Coordinates clinical review requests from payer sources to ensure timely reviews and ultimately timely payments to the hospital.
Attend and actively participate in all departmental and interdepartmental meetings relative to Case
Associate’s Degree in Nursing, Bachelor’s Degree in Nursing (preferred)
At least three (3) years of clinical experience in a hospital setting and at least two (2) years of case management experience in a hospital setting
Certification in case management (preferred)
Current unrestricted Registered Nurse license in the State of Colorado (required)
Willing to obtain Case management certification within 3 years
Internal Number: 1
About Community Hospital
ABOUT COMMUNITY HOSPITAL:
Community Hospital in Grand Junction, Colorado, is a full-service, acute-care hospital licensed for 60 beds. As part of the Colorado West Healthcare System, we offer full outpatient diagnostic services and inpatient care for the Western Slope region of Colorado, and eastern Utah. Community Hospital brings together expert staff and world-class technology in a healing, family-centered environment. We provide a full range of medical services, including inpatient and outpatient surgery and emergency care.
We pride ourselves on delivering personalized care to our patients, and in working closely with our medical-care providers in treating the whole person. This approach has resonated with our patients, and we are growing to meet our community’s demand. Our NEW four-story, 140,000 square foot, hospital opened Thursday, March 17th, 2016!
WHERE WE LIVE:
Grand Junction is located in beautiful Western Colorado and is the largest city in between Denver and Salt Lake City. Grand Junction is an outdoor lover’s paradise with hundreds of miles of mountain biking and hiking right out your front door. There is fantastic winter and summer activities including skiin...g, snowmobiling, snowshoeing, camping, and hiking. Enjoy the numerous lakes and rivers that supply abundant opportunities for boating, rafting, paddle boarding, and fishing. Avoid the traffic with close access to world class skiing in Aspen, Telluride, Vail, and Crested Butte. Come and tour one of the valley's 24 unique wineries and explore downtown Main Street with unique shops and delicious cafes and restaurants. Journey through the awe-inspiring Colorado National Monument or catch an event at Colorado Mesa University or a Grand Junction Rockies baseball game. Your activity options are endless in Western Colorado!
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