RN Inpatient Acute Case Manager
2 weeks ago
We are seeking a skilled RN Inpatient Acute Case Manager to join our team at Heritage Provider Network. As a key member of our Utilization Review Department, you will play a critical role in ensuring the efficient and effective delivery of care to our patients.
Key Responsibilities- Conduct thorough patient interviews to assess, identify, and evaluate discharge plans, including activity level, POA or contact person information, durable medical equipment needs, social network or barriers to care, advanced directives, anticipated discharge needs, medical history, hospital admission diagnosis, education of disease process, concurrent review with justification of stay, and anticipated discharge plan.
- Perform daily concurrent review on assigned patients, assessing chart review for evaluation of appropriate level of care, identifying barriers to treatment and reporting to V.P.HBS, proactively reaching out to expedite procedures or consults, facilitating patients' progress through the continuum of care, and reporting aberrant bed days per policy.
- Maintain communication with attending physicians throughout the hospital stay to discuss procedures, consults, patient progress, barriers to care, and patient status regarding any utilization of hospital services or problems noted.
- Work with attending physicians to identify discharge needs and facilitate discharge plans.
- Perform daily utilization review with Medical Director and V.P. HBS or designee regarding status of all hospitalized patients.
- Be proactive with treatment options, aggressively assist in information gathering to allow for continuity of care, assist with patient problems as assigned by the Medical Director and V.P HBS, proactively gather information to specialty and attending pertinent information to support transitions in levels of care, educate patients and caregivers regarding Advance Directives, strive for positive and professional relationships with providers, patients, and families, ensure a smooth transition of care after discharge, initiate/participate in Code Red, Code White, and Code Blue situations, require effective communication with involved healthcare providers, require familiarity with the clinical structure of BFMC and the healthcare services with which it contracts, act in a proactive manner to the benefit of the patient regardless of setting, communicate with attending physicians regarding any utilization of hospital services or problems noted, establish and maintain a functional familiarity with all contract services with which we deal, evaluate each patient's support system, understand patient benefits, and help establish expectations for service within those benefit limits.
- Graduate from an accredited Registered Nursing program or Licensed Vocational Nursing.
- Current California RN or LVN license.
- Current BLS certification.
- Minimum of two years clinical nursing experience.
- Minimum of one year utilization review experience.
- Ability to utilize electronic mail effectively.
- Supervisory experience preferred.
The pay range for this position at commencement of employment is expected to be between $53.77 and $63.26, however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience. If hired, employee will be in an "at-will position" and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.
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RN Inpatient Acute Case Manager
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Bakersfield, California, United States Heritage Provider Network Full timeJob SummaryWe are seeking a skilled RN Inpatient Acute Case Manager to join our team at Heritage Provider Network. As a key member of our Utilization Review Department, you will play a critical role in ensuring the efficient and effective delivery of care to our patients.Key ResponsibilitiesConduct thorough patient assessments to identify discharge needs and...
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