Discharge Planner RN
2 weeks ago
Baptist Health is a leading healthcare system serving central Alabama, providing comprehensive hospital-based and outpatient services to nearly 60 percent of the residents in Montgomery, Autauga and Elmore counties.
The RN Case Manager will be utilized as either Utilization Management or as Discharge Planning.
Key Responsibilities:- Coordinate care of an assigned caseload of patients through collaboration with physicians, nursing staff, and other health professionals to facilitate efficient utilization of clinical resources.
- Provide a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive human service needs.
- Work in collaboration with the patient/family, and interdisciplinary team (including physicians, other care providers, and payers), and assesses the patient care progression from acute care episode through post discharge for quality, efficiency, and effectiveness.
- Reconcile physician orders, bed billing type, and medical necessity in accordance with federal regulations, Insurance guidelines and Baptist Health's Utilization Management Plan.
- Protect revenue by ensuring accurate and timely completion of admission, continued stay, and discharge reviews.
- Active RN license required.
- BSN preferred.
- At least 2 years hospital patient care experience required.
- Previous experience in home care, reimbursement, or hospital insurance preferred.
- Previous inpatient hospital case management experience including utilization review (third party payor reimbursement, DRGs), and home care.
- Case Manager certification preferred.
- Basic computer skills required.
- Knowledgeable in use of appropriate infection control or isolation techniques when necessary.
- Strong oral, written and interpersonal skills.
- Ability to work independently with minimal supervision.
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