The Care Manager combines clinical expertise with knowledge of medical appropriateness criteria, and applies principles of utilization and quality management, discharge planning and the management of clinical/financial resources as a facilitator and consultant to the multidisciplinary patient care team. The Care Manager predicts, facilitates and evaluates the transition of patients across the care continuum and ensures linkages with post-acute discharge providers.

 

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Education and Experience

Minimum Required Education: RN licensure required

Preferred Education: BSN

Experience: At least three years of clinical nursing experience required.  Utilization management, discharge, planning, home health, and/or ambulatory experience preferred.  Knowledge of database, internet, spreadsheet and word processing software preferred.

 

Certificates, Licenses, Registrations

CCM, ACM or related certification required within 2 years of eligibility for the exam (preferred)