Registered Nurse Case Manager

Employment Type:Full timeShift:Day ShiftDescription:At MercyOne, health care is more than just a doctor's visit or a place to go when you're in need of medical attention. Our Mission is based on improving the health of our communities - that means not only when you are sick but keeping you well.MercyOne Dyersville Medical Center is a 20-bed critical access hospital serving 17 rural communities in western Dubuque County, offering the following services: Emergency/Trauma, Acute and Skilled Care, Rehabilitation Services (PT/OT/Speech), Ambulatory Surgery, Home Care, and Specialty Clinics. MercyOne is committed to providing quality, personalized and safe health care close to home.POSITION PURPOSEThe Case Manager coordinates care across an episode and/or the continuum for clients with complex problems and diverse needs. The Case Manager's focus is to maintain patients at an optimal level of health and to support self-care. Case Managers collaborate with physicians, social services, nurses, and community agencies to define care options and resources, to plan cost effective quality care and to achieve optimal outcomes.Specific responsibilities include case screening, insurance approval, assurance of timely services, and facilitation of discharge with transition to the appropriate services. Patient outcomes are achieved through effective application of care plans, managed care concepts, appropriateness criteria, resource management, knowledge of community resources, and collaboration with other clinical disciplines. Works proactively to coordinate the services of physicians, nurses, and other disciplines to effectively prepare patients for discharge. The Case Manager facilitates program development, efficient care delivery processes and quality improvement including tracking of resource utilization and outcome measures. The Case Manager is accountable for improving service using cost and quality outcome data, current clinical practices and related research, regulatory requirements and comparative benchmark opportunities.Customers include patients, families/visitors, physicians, physician assistants, nurse practitioners, case managers, representatives of third-party payers, representatives of referring agencies, interdepartmental and intradepartmental staff, vendors, and volunteers.ESSENTIAL FUNCTIONSActively knows, understands, incorporates, and demonstrates the organization's mission and core values, including the Guiding Behaviors and Caring Model Principles, and always conducts oneself in a manner consistent with these values.Maintains a working knowledge of applicable Federal, State and local laws and regulations, Trinity Health's Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical and professional behavior. Demonstrates knowledge, skills and abilities to provide case management servicesappropriate tothe age of patients served. Exhibits sound judgment, critical thinking, problemsolvinganddecision-makingskills. Communicates effectively with patients, significant others, and members of the health care team. Compiles information; keeps records, prepares or directs preparation of reports and correspondence. Executes dailyutilizationfunctions for assigned patients, including prior authorization, admission, precertification/certification/recertification, concurrent and retrospective review, associated analysis, and referral appropriateness. Participates in comprehensive team meetings and conferencesregardingspecific patient needs that affect cost, quality, and length of stay. Demonstratesabilityto promote collaboration and creativity among members of the health care team. Responsible for assuring thorough case management assessment, as well as early and ongoing discharge plans by collaborating with patients, families,physician, payors, and providers across the continuum of care. Reports potential catastrophic andhigh-costcases to department director, nursing director, and finance department forappropriate medical/administrativereview and management. Effectively manages length of stay and cost avoidance. Discuss cases with Utilization Review Committee and/or Executive Health Resources (EHR) when casesfail tomeet admission, treatment, and length of stay and/or discharge standards. Attends meetings of the Utilization Review Committee andsubmitsreports as required. Participates in the development of a written plan that describes the Utilization Review Program. Applies quality improvement methods and techniques to improve case management processes to maximize cost and quality benefits forMercyOneMedical Center. Performs other duties consistent with the purpose of the job as directed. Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health's Organizational Integrity Program, Standards of Conduct, as well as other policies and proceduresin order toensure adherence in a manner that reflects honest, ethical, and professional behavior. MINIMUM QUALIFICATIONS Must be a registered nurse and must hold an active license to practice nursing in the state of Iowa. Knowledge of clinical practice and case management processes normallyacquiredby completing abachelor's degree in nursing. Training and/or Certificationin the area ofcase management is preferred. Must meet all mandatory education and training requirements within specifiedtimeframesas required by organizational/regulatory standards. Three to five years' clinical experiencerequired. Clinical competency in the case management of rehab populationdesirable. Broad-based health care operational experience preferred. Computer Proficiency: Demonstrated experience and competency with Microsoft Office Suite, e-mail and a variety of web-based programs and browsers, with the willingness and ability to update and increase skills as needed to meet the goals of the departments. Demonstrates specific knowledge related to software programs such as Cerner/PowerChart,HealthQuest, UDS, and otherappropriate softwareprograms usedduringcase management processes. Ability to use other software asrequiredto perform the essential functions of the job. Maintains a professional, collaborative work environmentso as tofoster a positive public image forMercyOneMedical Center. Knows and adheres to all laws and regulationspertaining topatient health,safetyand medical information (i.e.HIPAA, Stark, etc.) Demonstrates the ability to work independently, and the ability to work collaboratively in a team environment. Providesa high levelof customer responsiveness and serves as a role model to encourage a commitment to customer service. A strong service orientation isrequired. Maintains an excellent working relationship within the department and withall ofour internal and external customers. Ability to handle interactions with discretion, tact and courtesy when dealing with sensitive issues and confidential information. Must have well developed communication skills; strong interpersonal and collaborative skills with physicians and other healthcare professionals; strongdecision-makingskills that support patient care needs and ethical standards; and the ability to organize work and setappropriate priorities. Must have excellent written and verbal communication skills with the ability to relate to people across all levels and diverse backgrounds. Ensures that services are provided in a manner that supports continuous quality improvement and customer-oriented focus. Keeps supervisor informed aboutimportant issues. Requires professionalism in both dress and conduct on the job. Demonstrates an understanding of organizational dynamics and administrative procedures and protocols. Ability to function in a dynamic, fast-paced team environment and to cope with ambiguity, time constraints, and other daily stressors in an effective andappropriate manner. Demonstrates time management, prioritization and organizational skills including an ability and willingness to plan, organize andaccomplishtasks accurately andin a timely mannerto exercise sound judgment under pressure and to manage multiple and competing activities simultaneously. Must be able to work independently and productively in afast-pacedsetting involving multi-task functions and projects. Ability to plan, organize and perform duties with minimal supervision and with a high degree of accuracy and attention to detail. Proven ability toidentify, compile and present data effectively from manydifferent sourcesfor management decision-making. Mustpossessadvanced analytical skills. Ability todemonstrateinitiative. Assigned hours within your shift, starting time, or days of work are subject to change based on the changing needs of the department and/or the organization. Visit MercyOne Careers (to learn more about the benefits, culture, and career development opportunities available to you at MercyOne Health System circle of care.Want to learn more about MercyOne D yersville ? Click here: Find a Location D yersville , Iowa (IA), MercyOne DyersvilleDyersvilleDyersville is known for its small-town charm and excellent schools in the Western Dubuque Community School District. Families enjoy safe neighborhoods, local parks and attractions like the Field of Dreams movie site. Community events and easy access to Dubuque add to its appeal.MercyOne Dyersville Medical Center is a 20bed critical access hospital serving 17 rural communities in western Dubuque County. As a Level IV Community Trauma Care Facility, it offers 24/7 emergency and trauma services, along with acute and skilled inpatient care, ambulatory surgery, home care and specialty clinics. The center includes a fully equipped laboratory, imaging services, retail pharmacy with drive thru and delivery and Phase II cardiac rehabilitation tailored to those recovering from heart events. Outpatient and inpatient physical, occupational and speech therapy are available locally to help patients regain function and independence. MercyOne Dyersville Medical Center delivers compassionate, personalized health care that keeps essential care close to home.Our CommitmentRooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.Our Commitment to Diversity and InclusionTrinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.EOE including disability/veteran

Created: 2026-03-08