RN Case Manager - OLGMC - full time

Ochsner Clinic Foundation • Lafayette, LA

10d • Onsite

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 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. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties. This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

Requirements

• Education Required - Graduate of an accredited school of nursing.
• Work Experience Required - None.
• Certifications Required - 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

• Preferred - Bachelor’s degree in nursing.
• Preferred - 3 years of hospital-based experience in discharge planning, case management or utilization review.
• Preferred - 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.
• 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.
• This employer maintains and complies with its 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.

What This Job Offers

• Job Type: Full-time
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees