Registered Nurse (RN) - Case Manager - Ochsner Baptist - Full Time

Ochsner Clinic Foundation•New Orleans, LA

8h•Onsite

About The Position

This role involves multi-disciplinary communication and facilitation of patient care throughout hospitalization, focusing on appropriate resource utilization and patient self-determination. The Case Manager reviews patient hospitalizations, recommends medically necessary levels of care, and ensures proper documentation. They act as a liaison between patients, caregivers, the multi-disciplinary team, post-acute care providers, and third-party payers. Collaboration with the care team is essential for developing and implementing individualized discharge plans. This job description is a summary and subject to change at the company's discretion.

Requirements

Registered nurse diploma or equivalent.
3 years of hospital-based experience.
Current registered nurse license in state of practice.
Basic Life Support (BLS) from the American Heart Association.
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).

Nice To Haves

Bachelors degree in nursing.
Experience in discharge planning, case management or utilization review.
Certification in Case Management (CCM) or Accredited Case Manager (ACM).

Responsibilities

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, 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.
Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.
Complies with the 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.