RN Case Manager - Per Diem

St. Francis is NOW HIRING a Per Diem RN- Case Manager to join the Case Management / Discharge Planning Team!

This is a PRN position to cover weekend shifts across the hospital. Looking for some extra money, this is the position for you!

POSITION SUMMARY :

The goal of hospital Case Management is resource coordination along a continuum to help patients to achieve optimal health, access to care and appropriate utilization of resources. Case managers work collaboratively with patients, nurses, physicians and other practitioners, caregivers and community resources and agencies to provide cost effective care that reflects a patient’s preferences and values. Healthcare is a right, and patients have choices. Our services should reflect that concept. Responsibilities of the floor case manager are as follows :

PRIMARY (ESSENTIAL) DUTIES :

• Manage census for DC planning for the floor you are assigned
• Review every status order and ensure accuracy. Handle inappropriate status orders per protocol
• Review all observation cases minimally twice daily
• Review all new admissions and provide UR to insurance companies per regulations
• Perform and submit continued stay reviews daily
• Perform continued stay reviews every 48 hours for payor not requiring submission
• Organize and plan discharges for the day
• Daily rounding with treatment team
• Perform high risk assessment on all patients when admitted
• Perform discharge screen / assessment on day one. Reassess every 48 hours
• Have patients sign choice letters, when needs are identified
• Make post-acute care referrals as need is identified
• Issue Important Message from Medicare letters initially if needed, and within 48hours prior to discharge
• Issue MOON to observation patients
• Issue HINNs as needed
• Complete Code 44’s as necessary
• Identify and review 30 day readmits. Collaborate with treatment team to prevent further readmissions
• Understand DRG / GMLOS to appropriately discharge plan in collaboration with physicians
• Avoidable days management
• Responsible for knowing and practicing the Utilization Management Plan

The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all the work requirements that may be inherent in the position.

ORGANIZATIONAL RELATIONSHIPS

Qualifications

Education :

Licenses / Certification :

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