RN Case Manager Care Management Full Time Days
Park Ridge Health has provided whole-person care to the Henderson County community for more than 100 years. Inspired by our mission of Extending the Healing Ministry of Christ, we continually look for ways to bring hope, health and healing to the patients we have the honor of caring for. As a member of Adventist Health System, one of the largest faith-based healthcare organizations in the U.S., we also offer world-class opportunities for our team members to learn, grow and serve across the nation.
Plan, coordinate, provide and document care for a geographically assigned caseload of patients from day of admission through day of discharge. Utilize physicians’ orders and professional skills to develop and implement a plan that meets each patient’s specific needs and is in compliance with JCAHO, federal and state regulations, reimbursement guidelines as well as agency policies and procedures.
- Initiate and maintain ongoing utilization review based upon knowledge of Integral screening criteria for all payers. Refer reviews to EHR and/or the Director of Care Management for identified reviews that fail to meet clear medical necessity.
- Participate in and initiate interdisciplinary patient care meetings as indicated by the needs of the patient. Provide current information to all members of the interdisciplinary care team.
- Verbally communicate and provide frequent feedback to physicians regarding patient discharge needs, resources and criteria.
- Assess, plan evaluate, implement and document discharge planning needs based upon current knowledge of available resources. Coordinate discharge planning with medical providers, the patient and significant others who have an ongoing caring relationship with the patient to ensure appropriate post-acute care services are arranged and agreed upon by all those involved
- Graduate of an accredited school of nursing required.
- Five years of acute care experience within the last ten years; and/or
- Five years of experience in one or a combination of the following: home healthcare, community health or public health, or outpatient facility experience.
- Current state licensure as a Registered Nurse required.