Care Management Coord RN-Optional

TriHealth•Montgomery, OH

4d•Onsite

About The Position

The Care Management Coordinator RN Opportunity at Bethesda North Hospital is a role within the Care Management department. This position is responsible for overseeing processes and documentation related to evidence-based practice at the bedside. It involves directing and completing functions of the government and commercial utilization management process, assessing and coordinating the implementation of the discharge plan, and collaborating with the multidisciplinary team to ensure effective, efficient, and appropriate care. The role aims to optimize patient health status and ensure smooth transitions between care levels. It requires performing utilization reviews for patients served and includes commitments for weekend, holiday, and off-site work, with the exception of Hospice of Cincinnati.

Requirements

Associate's Degree or Diploma in Nursing
BLS/CPR (Basic Life Support for Healthcare Providers)
Registered Nurse
Excellent communication skills
Ability to negotiate
Problem solve
Establish effective working relationship with members of the healthcare team and external customers
Knowledge & experience in computer key boarding
3-4 years experience Clinical in Nursing

Nice To Haves

BSN within 5 years of hire
Professional organization membership preferred

Responsibilities

Using current practice guidelines, assesses all patients, evaluating progress toward clinical goals and next level of care.
Reassesses as clinical condition changes.
Complete initial utilization review using Interqual criteria.
Take follow up action to resolve the situation when criteria are not met by implementing and documenting according to the Utilization Review plan.
Coordinate the development of a comprehensive plan of care through patient/family involvement in an interdisciplinary team process.
Ensure the patient's health care goals are met related to evidenced based quality care.
Ensure that all commercial and government payment requirements are met for continued stay reviews, and other conditions of participation.
Ensure that CMS requirements are met for patient status.