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    Case Manager Nurse - Morgantown, United States - WVU Medicine

    WVU Medicine
    WVU Medicine Morgantown, United States

    1 week ago

    Default job background
    Full time
    Description

    Job Title: Transition/Discharge Planner

    This position involves planning and managing resources for specific patient populations. Responsibilities include denial management, access to appropriate care levels, discharge planning, care coordination, and referrals to other care providers. Working closely with a multidisciplinary team to ensure desired treatment outcomes are achieved.

    Minimum Qualifications:

    • Current West Virginia RN licensure or equivalent

    Experience:

    • Five years of clinical experience

    Preferred Qualifications:

    • Bachelor's degree in Nursing (BSN)

    Core Duties and Responsibilities:

    • Manages transition/discharge planning for patients
    • Collaborates with the healthcare team for efficient transitions
    • Monitors patient progress and intervenes when necessary
    • Provides education to staff, physicians, patients, and families
    • Develops individualized transition plans with the patient and family
    • Facilitates referrals to post-acute services
    • Documents all transition activities and progress
    • Assists with medical power of attorney and advanced directives
    • Coordinates financial assistance and entitlement programs
    • Utilizes quality screens to identify potential issues
    • Completes clinical reviews and applies utilization criteria
    • Educates staff on payer regulations and managed care
    • Integrates staff and students into the healthcare team

    Physical Requirements:

    • Working closely with others
    • Protracted or irregular hours
    • Exposure to biohazards and infectious diseases
    • Handling water and patient care equipment

    Skills and Abilities:

    • Knowledge of medical insurance coverage and precertification requirements
    • Understanding of scientific principles and standards of care
    • Proficiency in administering treatments and nursing processes

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