RN Case Manager | Baylor Weekends | Full Time
Union General Hospital•Hiawassee, GA
9d
About The Position
The primary purpose of this job is to do case management as well as social services activities - and utilization review duties.
Requirements
- Associates degree/Bachelor degree in Nursing
- Licensed Registered Nurse (RN) - REQUIRED.
- ACLS and BLS certifications.
Nice To Haves
- Two years Case Management experience
- Med/Surg background
- Knowledge of Cerner and MCG (Indicia)
- Case Management experience
Responsibilities
- Complete chart reviews to: Assess medical necessity for the level of care and services provided using criteria as directed by the patient's payor sources; Document in the UR note and complete certifications or forward information to payor's as required by payor source; Assist quality department in compliance with core measures; Improve concurrent documentation to optimize quality of patient care and accurate reimbursement; Participate in denial management and complete the appeals process.
- Assess discharge needs of patients, document in medical record, meet discharge needs, and participate in multidisciplinary team meetings.
- Utilize strategies to decrease re-admissions (complete risk assessments on inpatients, obtain referrals as needed, coordinate care with patient, family and doctor.
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What This Job Offers
Job Type
Full-time
Education Level
Associate degree
