Registered Nurse (RN) - Case Manager - Ochsner Baptist

Ochsner Clinic Foundation•New Orleans, LA

1d•Onsite

About The Position

This job involves multi-disciplinary communication and facilitation of care throughout a patient’s hospitalization. It includes reviewing the appropriate utilization of resources, balanced with the patient’s right to self-determination. The role 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. The Case Manager may discuss alternative care options with the Emergency Department (ED) physician or attending physician. This role functions as a liaison, communicating with the patient, caregiver, multi-disciplinary team members, as well as post-acute care providers and third-party payers. The Case Manager collaborates with the care team to develop and implement discharge plans based on the patient’s individualized needs.

Requirements

Current State of Louisiana Registered Nurse License
Basic Life Support (BLS) from the American Heart Association
3 years Hospital-based experience.
Computer skills and dexterity required for data entry and retrieval of patient information.
Proficient with Windows-style applications and keyboard.
Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
Strong interpersonal skills

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.
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.