LPN Case Manager- Slidell

Ochsner Clinic Foundation • Slidell, LA

5d

About The Position

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. Come make a difference at Ochsner Health and discover your future today! This job coordinates, negotiates, procures and manages the care of complex patients to facilitate achievement of quality and cost outcomes for admission to the facility, diagnostic procedures, or clinical specialties. Serves as a resource for physician and multi-disciplinary team members to obtain information regarding current charges, reimbursement and payor source limitations.

Requirements

• Graduate of an accredited licensed practical nurse (LPN) program.
• 3 years of hospital-based experience.
• Current licensed practical nurse (LPN) license in the state of practice.
• Working knowledge of admission criteria including, International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes and Medical Necessity guidelines.
• Computer skills and dexterity for data entry and retrieval of information.
• Effective verbal and written communication skills and ability to present information clearly and professionally.
• Proficient with Windows-style applications, various software packages specific to role and keyboard.

Nice To Haves

• Experience in utilization review.

Responsibilities

• Performs pre-admission, admission, and continued stay reviews as directed per content management system (CMS) or commercial payer guidelines and/or hospital policy.
• Collaborates with hospital staff, as required, for authorization/certification processes.
• Explores strategies to reduce length of stay and resource consumption for case managed patient populations.
• Identifies appropriate patients for the various third-party payor pre-certification or pre-authorization process.
• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees