RN Case Manager - OLGMC - full time

Ochsner Health • Baton Rouge, LA

83d

About The Position

This job handles multi-disciplinary communications and facilitations of care throughout a patient’s hospitalization, which includes a review of the appropriate utilization of resources, balanced with the patient’s right to self-determination. 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. May discuss alternative care options with the Emergency Department (ED) physician or attending physician. Works as a liaison and communicates with the patient, caregiver, multi-disciplinary team members as well as post-acute and third-party payers. Collaborates with the care team to develop and implement discharge plans based on patient’s individualized needs.

Requirements

• Graduate of an accredited school of nursing.
• Current registered nurse license in state of practice.
• Basic Life Support (BLS) from the American Heart Association.

Nice To Haves

• Bachelor’s degree in nursing.
• 3 years of hospital-based 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 and 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.

Benefits

• Ochsner Health is an Equal Opportunity Employer.
• Opportunities for personal/professional development.
• Access to a supportive work environment.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Bachelor's degree