Graduate of an accredited school of Nursing or Social Work. Current RN or Social Work licensure in the state of WV. Bachelor's degree required. Master's degree preferred. Position requires a solid understanding of Interqual criteria CMS/JCAHO standards and requirements. Working knowledge of Case Management with knowledge of DRG payment system, hospital finance and managed care issues. Working knowledge of current documentation requirements relating to MSDRGs and POS criteria established by CMS. Interpersonal skills to obtain an interpret information appropriate of patients’ needs and age as required for assessment, range of treatment and patient care. Advanced communication and interpersonal skills with all levels of internal and external customers. Computer skills including MS Word, spreadsheets, email and use of current utilization review/case management internet review systems (Navinet, etc) |
Skills in assessing, planning and managing patient care as acquired through a minimum of five years of clinical experience in an acute care hospital and a minimum two years Case Management experience required. Experience in managing a Case Management department and certification in Case Management preferred.
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