- Proficiency in using computers, software, and web-based applications.
- Effective verbal and written communication skills and ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
- Strong interpersonal skills.
- Ability to work a flexible work schedule (e.g. 24/7, weekend, holiday, on call availability).
- Performs pre-admission, admission, and continued stay reviews as directed per CMS guidelines, commercial payer guidelines, and/or hospital policy.
- Supports the values of service excellence, teamwork and integrity and maintains minimum standards for licensure and strives for personal/professional development.
- Maintains knowledge of the conditions of participation as it relates to utilization review and discharge planning.
- Maintains open communication with all appropriate parties while functioning as a liaison between ED physicians, hospitalists, attending physicians, and physician advisors.
- Leads the oversight and management of the functional and financial outcomes, including coordination and implementation of the discharge plan, during the acute-care hospitalization.
- Adapts behavior to the specific patient population, including but not limited to respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions and communication style.
- Performs other related duties as required.
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rn case manager - Kaplan, LA , USA, United States - Ochsner Health System
Description
We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate.
We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.
At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters.
This job handles multi-disciplinary communications and facilitations of care throughout a patient's hospitalization, which includes a review of the appropriate utilization of resources, balanced with the patient's right to self-determination.
Reviews patient hospitalizations, recommends a level of care that meets medically necessary hospital care criteria, and confirms a clear, specific level of care order and other appropriate documentation in the medical record.
May discuss alternative care options with the Emergency Department (ED) physician or attending physician.Works as a liaison and communicates with the patient, caregiver, multi-disciplinary team members as well as post-acute and third-party payers.
Collaborates with the care team to develop and implement discharge plans based on patient's individualized needs.This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.
Education
Required -Registered nurse diploma or equivalent.
Preferred -Bachelor's degree in nursing.
Work Experience
Required -None.
Preferred -3 years of hospital-based experience in discharge planning, case management or utilization review.
Certifications
Required -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).
Knowledge Skills and Abilities (KSAs)
This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.
Physical and Environmental Demands
The physical essential functions of this job include (but are not limited to) the following: Frequently exerting 10 to 20 pounds of force to move objects; occasionally exerting up to 100 pounds of force.
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 communicable diseases.
Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste.
Are you ready to make a difference? Apply Today
Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website.
Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Washington, and New York.
We are proud to be an Equal Employment Opportunity and Affirmative Action employer.
We are committed to the principles of equal employment opportunity and providing a workplace that is free from discrimination based on race, color, creed, religion, pregnancy status, pregnancy-related conditions, national origin, ancestry, mental or physical disability, medical condition, age, veteran status, military status, citizenship status, marital status, familial status, sexual orientation, gender, gender identity or expression, genetic information, political affiliation, unemployment status, or any other characteristic protected under applicable federal, state or local law.
These protections extend to applicants and all employment related decisions.View the EEO is the Law poster and its supplement, as well as the pay transparency policy for more information.
Affirmative Action Policy Statement
