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    Certification Details
  • Current CA RN License
  • Completion of BLS and ACLS certification
    Job Details
  • RN Case Manager with acute hospital discharge planning experience; inpatient acute rehabilitation preferred.
  • This position coordinates the utilization management, resource management, discharge planning, post-acute care referrals and care facilitation.
  • This position oversees the management of acute patient populations across the care continuum with a focus to provide coordinated and integrated care to prevent unnecessary admissions or readmissions.
  • Provides discharge planning coordination and Intervention for the high risk patient presenting to the Emergency Department.
  • This position strives to promote patient wellness, improved care outcomes, efficient utilization of health services and minimized denials of payment among a patient population with complex health needs.
  • JOB ACCOUNTABILITIES:
  • - Patient Initial and Concurrent Screening.
  • - Reviews initial physician admission care plan.
  • - Gathers additional medical, psychosocial and financial information from patient/family interview, medical record assessment, physicians and other health care providers.
  • - Determines moderate or high-risk level for readmission.
  • - Conducts screening for ancillary supportive services.
  • - Functionally supervises and leads the health care team in developing comprehensive, cost-effective care coordination plans.
  • - Performs cost benefit analysis of care options.
  • - Formulates a transition plan after reviewing available/appropriate care options with input from the patient/family, physicians, health care team, and community.
  • - Identifies and refers quality and risk management concerns for corrective action plans and trending.
  • - Directs and oversees Assistants to interview patient/family and determine preferences for post-acute care services.
  • - Utilization Management: Completes initial InterQual review screening upon admission and performs continued stay and discharge planning reviews.
  • - Monitors Length of Stay and outliers requiring additional resources and/or focus and reports to management.
  • - Collaborates with interdisciplinary team to assure timely discharge.
  • - Maintains an average Utilization Review accuracy rate at or above the goal.
  • - Follows policies and procedures for Physician Advisor referrals.
  • - Facilitates discharge of patients from the Emergency Department to alternate care settings.
  • - Initiates timely communication with admitting physicians when medical necessity deficiencies are identified.
  • - Care Coordination/Care Transitions: Performs initial screening on all hospitalized patients to identify case management needs.
  • - Proactively identifies barriers to discharge and works with multi-disciplinary team to expedite care, monitor length of stay and facilitate discharge.
    Job Requirements
  • CA RN License
  • BLS
  • ACLS

Read the full job description and apply online on the recuiter's web-site

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