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Registered Nurse (RN) Case Manager Gordon Hospital

Req #: 17010638
Location: Calhoun, GA
Job Category: Case Management
Organization: Gordon Hospital and Murray Medical Center
Description

Work Hours/Shifts


Gordon Hospital

Gordon Hospital is a 69-bed community hospital that is a member of Adventist Health System, the largest not-for-profit Protestant healthcare system in the world. We provide high quality, personalized and compassionate care to its patients and community. Through our dedication to safety, rigorous self-assessment, performance improvement, corporate integrity, and service management, we are committed to being the pre-eminent provider of acute inpatient and outpatient healthcare services for the residents of Calhoun, Gordon County, and surrounding areas.

Qualifications

GENERAL SUMMARY:

 

The Case Manager is responsible for the timely facilitation of quality healthcare services to meet patient specific needs, promote positive patient outcomes, effectively use resources and contain healthcare cost.  The Case Manager will evaluate and assess patient specific data and validate by signature data documented.   The Case Manager is responsible to know, understand and adhere to facility policy and regulatory law.

 

 

 

You will be responsible for:

  • Review inpatient and observation admissions and continued stays for appropriateness concurrently and retrospectively.

  • Accurate application and documentation of admission and continued stay criteria

  • Document insurance contact information, authorization numbers, referrals to Physician Advisor, discharge assessments in the CareManager system.

  • Contact insurance companies/Medicaid via phone, fax or WEB to obtain certification for inpatient and outpatient services.

  • Coordinates with medical offices regarding outpatient certifications, as required.

  • Identify patients at risk for discharge needs early in admission, initiate contact with patient/family and proactively refer for necessary resources.

  • Consult with patients, family, staff and physicians regarding complex care and social problems such as mental health or DFACS referrals, transfers to other facilities, etc.

  • Communicate with patient, family, physician and interdisciplinary team regarding DCP.

  • Attend discharge planning meetings interdisciplinary rounds. 

  • Consult with physicians regarding discharge needs, utilization questions and available resources.

 

will process upfront applications

 

What will you need?

 

 

  • 5 years general broad based nursing experience strongly preferred.

  • Broad Base of general nursing

  • Acute hospital direct patient care

  • Knowledge of Standards of Care

  • Certification in Case Management is desired.

  • BLS

  • RN or MSW licensure in the State of Georgia

  • 2 or more years’ experience in acute hospital case management

  • Knowledge of EMR Preferred

  • Knowledge of Microsoft Office Preferred

  • Bachelors of Nursing or Masters in Clinical Social Work. Preferred

  • 2 years Case Management Experience Preferred

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