Case Manager - RN (Hospital) $15,000 Hiring Incentive
Company: Noland Hospital Birmingham - Downtown
Location: Birmingham
Posted on: May 9, 2024
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Job Description:
New LTAC Hospital Located inside St. Vincents MainIND123Summary
of Duties:Assesses and plans for care that effectively manages the
adult and geriatric patient. Performs utilization review for
medical necessity with established severity of illness/intensity of
service criteria to determine appropriateness of admission,
continued stay level of service, and discharge indicators.
Evaluates and implements appropriate discharge planning designed to
meet individual patient and family needs.Essential Job Functions:*
Implements appropriate case management services to meet
patient/family/significant other needs related to continued care,
discharge planning, finances, etc.* Demonstrates that outcomes of
patient care are within the appropriate length of stay, facilitates
appropriate/effective utilization of resources, and ensures that
established standards are met through collaboration with the
inter-disciplinary healthcare team and the
patient/family/significant other.* Makes appropriate referrals to
physician advisor when documented care does not reflect defined
criteria (SI/IS) per specific payor.* Conducts a systematic
discharge planning assessment of all patients on admission.
Assesses all required elements of discharge planning as required by
regulatory and accrediting bodies.* Works with Coding Specialist in
the assignment and reassignment of DRGs as necessary.* Communicates
to appropriate referral sources to assist in discharge planning and
ensures completion of patient consent/provider choice
documentation.* Assists in facilitating and implementing physician
orders to aid in the timely completion of patient care across the
continuum.* Identifies and reports opportunities to improve care
for patients in the organization, including patient complaint
management and any unusual patient care issues.* Assesses all
patient care documentation for utilization review monitoring for
medical necessity severity of illness/intensity of service as
required by payor.* Coordinates appropriate utilization of
resources throughout patients hospitalization. Identifies and
evaluates for over/under utilization of resources and delays.
Identifies areas for improvement.* Assists in the development,
implementation, and monitoring of organizational performance
improvement. Accurately collects data for various case management
processes for internal and external benchmarking as indicated.*
Educates or causes education to occur for
patient/family/significant other regarding continuum of care
resources, effective and efficient use of equipment and supplies,
and community resources available.* Submits appropriate clinical
documentation to coder for assignment of a working DRG following
the admission of a patient.* Updates Coding Specialist on changes
to patients conditions that may affect DRG assignments.*
Facilitates physician queries and subsequent appropriate
documentation.* Manages patients hospital stay to achieve an in the
window discharge whenever possible.* Performs pre-admission
assessments, insurance verifications, and medical necessity
evaluations as well as write admission orders in the absence of the
Clinical Marketing Liaison.Education:Must hold current nursing
license in the State of Alabama. BSN preferred.Experience:Minimum
of three (3) years experience in nursing required. Minimum of two
(2) years experience in an acute care hospital setting
preferred.Physical Requirements for Essential Job Functions:* Must
be able to walk, sit, stoop, or stand intermittently throughout the
workday.* Must be able to work with hands and fingers throughout
the workday.* Must possess sight/hearing senses or use prosthetics
that will enable senses to function adequately so that requirements
of the position can be fully met.* Must be able to reach in any
direction intermittently throughout the workday.by Jobble
Keywords: Noland Hospital Birmingham - Downtown, Birmingham , Case Manager - RN (Hospital) $15,000 Hiring Incentive, Executive , Birmingham, Alabama
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