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Registered Nurse Case Coordinator
2 months ago
We are dedicated to providing exceptional, evidence-based care for our patients, ensuring they receive the necessary treatment regardless of their payment source.
Case Management Approach:
Employ an Integrated Case Management Approach. Case Coordinators will support patients throughout their healthcare journey to ensure seamless care coordination, status monitoring, and effective discharge planning.
Key Responsibilities
- Conduct clinical evaluations of hospitalized patients to assess medical necessity for admission.
- Oversee cases for ongoing care, level of service, and quality assurance.
- Obtain authorization for all services rendered from external payers.
- Facilitate patient status modifications as required based on clinical assessments.
- Collaborate with various departments to address financial matters.
- Assist in the denial and appeals process.
- Formulate discharge plans and provide education to patients and their families regarding recommendations.
- Identify potential obstacles to discharge and coordinate referrals for resolution.
- Gather and relay data on care quality and operational effectiveness.
KNOWLEDGE AND SKILLS:
Specialized expertise and abilities necessary to fulfill the role's responsibilities.
EDUCATION:
Bachelor's Degree in Nursing.
YEARS OF EXPERIENCE:
3-5 years of experience in medical/surgical nursing; case management experience is preferred.
REQUIRED SKILLS AND KNOWLEDGE:
Proficiency in case management, utilization review, and discharge planning.
LICENSES & CERTIFICATIONS:
Licensed to practice in the State of Ohio. Certification in Case Management (CCM) or Accreditation in Case Management (ACM) is preferred.
About Our Organization
The Christ Hospital has been a prominent provider of healthcare services in the Greater Cincinnati area for over 130 years. Our organizational culture prioritizes collaboration, diversity, and innovation to improve the quality and accessibility of healthcare.
