RN Case Manager
Ochsner Health • Slidell, LA13d
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RN- Case Manager- Slidell- PRN
Ochsner Health•Slidell, LA
About The Position
The RN Case Manager coordinates multidisciplinary communications and facilitates care throughout a patient’s hospitalization. The role reviews utilization of resources while respecting patients’ right to self-determination, evaluates hospitalizations against medically necessary care criteria, recommends an appropriate level of care, and ensures the medical record contains a clear level-of-care order and other appropriate documentation. The Case Manager may discuss alternative care options with ED or attending physicians and serves as a liaison among patients, caregivers, multidisciplinary team members, post-acute providers, and third-party payers. The role collaborates with the care team to develop and implement discharge plans based on each patient’s individual needs. The position performs pre-admission, admission, and continued-stay reviews according to CMS and commercial payer guidelines or hospital policy. It oversees functional and financial outcomes during acute-care hospitalization, including coordination and implementation of discharge plans. The Case Manager maintains knowledge of applicable utilization review and discharge-planning requirements, laws, accreditation standards, and regulations, and adapts communication and care processes to the needs and privacy of specific patient populations. The job requires graduation from an accredited school of nursing and a current registered nurse license in the state of practice, as well as BLS certification from the American Heart Association. No prior work experience is required. Hospital-based experience in discharge planning, case management, or utilization review and a nursing bachelor’s degree are preferred. The role is PRN and requires the ability to work a flexible schedule, which may include 24/7 coverage, weekends, holidays, and on-call availability. The position is performed in a patient-care healthcare environment. Duties routinely involve potential exposure to blood, body fluids, tissue, communicable diseases, hazardous medications, and hazardous waste. The physical demand classification is Medium Work, involving exertion of 20 to 50 pounds occasionally, 10 to 25 pounds frequently, and up to 10 pounds constantly to move objects.
Requirements
- Graduate of an accredited school of nursing.
- Current registered nurse license in the state of practice.
- Basic Life Support (BLS) certification from the American Heart Association.
- Proficiency with computers, software, and web-based applications.
- Effective verbal and written communication skills, including the ability to present information clearly and professionally to people at varying levels.
- Strong interpersonal skills.
- Ability to work a flexible schedule, including possible 24/7 coverage, weekends, holidays, and on-call availability.
Nice To Haves
- Bachelor’s degree in nursing.
- Three years of hospital-based experience in discharge planning, case management, or utilization review.
- Certification in Case Management (CCM) or Accredited Case Manager (ACM).
Responsibilities
- Perform pre-admission, admission, and continued-stay reviews according to CMS guidelines, commercial payer guidelines, and/or hospital policy.
- Review hospitalizations and recommend a medically necessary level of care; confirm that the medical record contains a clear, specific level-of-care order and appropriate documentation.
- Discuss alternative care options with ED physicians or attending physicians when appropriate.
- Communicate and act as a liaison among patients, caregivers, ED physicians, hospitalists, attending physicians, physician advisors, multidisciplinary team members, post-acute providers, and third-party payers.
- Collaborate with the care team to develop and implement individualized discharge plans.
- Lead oversight and management of functional and financial outcomes during acute-care hospitalization, including coordination and implementation of discharge plans.
- Maintain open communication with appropriate parties throughout the patient-care process.
- Maintain knowledge of conditions of participation related to utilization review and discharge planning.
- Adapt behavior, introductions, explanations, permissions, and communication style to the specific patient population while respecting privacy.
- Maintain knowledge of applicable federal, state, and local laws, accreditation standards, and regulatory requirements, and ensure compliance.
- Support service excellence, teamwork, and integrity; maintain licensure standards and pursue personal and professional development.
- Perform other related duties as required.
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What This Job Offers
Education Level
Associate degree
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