EvergreenHealth is seeking an experienced RN to join the Care Management Team. The RN in our Care Management department specializes in assessing hospital admissions for status per defined criteria and reviews for appropriate utilization of resources. This role ensures continuity and coordination of care for patients before, during, and after hospitalization, and ensures that payer conditions are met. In conjunction with the interdisciplinary team, the RN supervises progress and recommends appropriate clinical interventions to nursing staff and attending physicians, ensuring CMS guidelines are met. The RN also ensures that patients and families have access to resources for post-hospital care needs, monitors patients' medical progress, identifies and addresses patient needs/gaps in service as they move through the system, and obtains authorization for discharge planning as appropriate. Additionally, the RN takes action to correct variances in length of stay by following up with physicians and payers as needed, provides utilization reviews, meeting all time requirements, and addresses the discharge appeal process in collaboration with the physician, Director/Manager, and/or Social Worker. Other duties may be assigned as needed.
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Job Type
Full-time
Career Level
Mid Level
Industry
Hospitals
Education Level
Bachelor's degree