RN Case Manager

2 weeks ago


Towanda, Kansas, United States Ochsner LSU Full time
Job Summary

This role involves coordinating patient care throughout their hospitalization, ensuring appropriate resource utilization and patient self-determination. The RN Case Manager will review patient hospitalizations, recommend a level of care that meets medically necessary hospital care criteria, and confirm a clear, specific level of care order and other appropriate documentation in the medical record.

Key Responsibilities
  • Perform pre-admission, admission, and continued stay reviews as directed per CMS guidelines, commercial payer guidelines, and/or hospital policy.
  • Support the values of service excellence, teamwork, and integrity and maintain minimum standards for licensure and strive for personal/professional development.
  • Maintain knowledge of the conditions of participation as it relates to utilization review and discharge planning.
  • Communicate effectively with patients, caregivers, multi-disciplinary team members, post-acute, and third-party payers.
  • Collaborate with the care team to develop and implement discharge plans based on patient's individualized needs.
Requirements
  • Registered nurse diploma or equivalent.
  • Preferred: Bachelors degree in nursing.
  • Current registered nurse license in state of practice.
  • Basic Life Support (BLS) from the American Heart Association.
  • Preferred: Certification in Case Management (CCM) or Accredited Case Manager (ACM).
Physical and Environmental Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects.

Duties performed routinely require exposure to blood, body fluid, and tissue. The incumbent works in a patient care area; works in an area where patients enter; works directly with patients; and/or works with specimens that could contain diseases.


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