Case Manager (Either Rn Or Msw)

This position can be filled by either an RN Case Manager or an MSW Case Manager. See below for requirements for each position.

Job Summary

Under the general supervision of the Supervisor and/or Manager, and according to established policies and procedures, the MSW or RN Case Manager coordinates, negotiates, and manages the care of patients to facilitate achievement of positive clinical and financial outcomes. Works collaboratively with interdisciplinary staff, internal and external to the organization, to facilitate appropriate delivery of healthcare services. The MSW or RN Case Manager integrates the roles of Case Management and Discharge Planning utilizing a prospective approach for planning the ways in which patient care will be provided, the steps in the care process, and the outcomes of care. This role's objective is to promote a collaborative interdisciplinary care delivery model to achieve optimal clinical, satisfaction, and financial outcomes. The MSW or RN Case Manager participates in quality improvement and evaluation processes related to management of patient care. Work is of a highly confidential nature.

MSW Case Manager Minimum Qualifications

Education: Master's Degree from an accredited school of Social Work.

Experience: At least 2 years of acute care hospital case management experience.

Licensure/Certification: Currently licensed by the State Board of Social Work Examiners for S.C. Preference will be given to those with Case Management Certification.

Primary Source Verification (if applicable): Social Worker- Labor, Licensing and Regulation (LLR): http://verify.llronline.com/LicLookup/LookupMain.aspx

RN Case Manager Minimum Qualifications

Education: Effective April 9, 2023, Bachelor's degree in Nursing from an accredited college/university required. Teammates hired into this position prior to April 9, 2023, must have an ADN from an accredited school or college of nursing.

Experience: At least 1 year of clinical acute care experience as an RN or Case Manager, preferably within the last 5 years. Utilization Review and Case Management experience preferred.

Licensure/Certification: Currently licensed as a Registered Nurse in the state of South Carolina or holds a current compact/multi-state license as a Registered Nurse in a recognized NCSBN Compact State and is not a permanent resident of SC. Utilization Review and Case Management certification preferred.

Primary Source Verification (if applicable): Nursing - SC Labor, Licensing and Regulation (LLR): http://verify.llronline.com/LicLookup/LookupMain.aspx- or compact RN state licensing board.

Knowledge/Skills: Demonstrates knowledge of community resources, government and commercial payer programs benefits and eligibility, and post-acute service regulatory requirements. Demonstrates knowledge of reimbursement systems, the ability to educate patients and families regarding payer requirements / coverage for post-acute care services and the ability to effectively advocate on behalf of the patient to obtain authorizations for continued care as appropriate. Maintains working knowledge of post -transition of care options based on facilities capabilities and funding accepted. Maintains a working relationship with external providers, services, agencies to facilitate the transition of care. Requires high level negotiation skills and confidence in communicating with and engaging in crucial conversations with physicians and entire healthcare team.

Other: Requires excellent oral and written communications skills. Ability to work in a fast pace team environment. Ability to prioritize and multi-task. Ability to make sound judgments and act professionally under pressure. Ability to maintain confidentiality of sensitive patient information. Must have ability to solve problems independently, prioritize work and design creative solutions when resources or options for discharge are limited.

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