RN Case Manager - OLGMC

Overview

We ve made a lot of progress since opening the doors in 1942, and our commitment to serve, heal, lead, educate, and innovate remains. At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!

This job handles multi-disciplinary communications and facilitation of care throughout a patient’s hospitalization, including review of appropriate utilization of resources, balanced with the patient’s right to self-determination. Reviews patient hospitalizations, recommends a level of care that meets medically necessary hospital care criteria, and confirms a clear, specific level of care order and other appropriate documentation in the medical record. May discuss alternative care options with the Emergency Department (ED) physician or attending physician.

Acts as a liaison and communicates with the patient, caregiver, multi-disciplinary team members as well as post-acute and third-party payers. Collaborates with the care team to develop and implement discharge plans based on the patient’s individualized needs.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

Required - Graduate of an accredited school of nursing.

Preferred - Bachelor’s degree in nursing.

Required - None.

Preferred - 3 years of hospital-based experience in discharge planning, case management or utilization review.

Required - Current registered nurse license in state of practice.

Basic Life Support (BLS) from the American Heart Association.

Preferred - Certification in Case Management (CCM) or Accredited Case Manager (ACM).

• Proficiency in using computers, software, and web-based applications.
• Effective verbal and written communication skills and ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
• Strong interpersonal skills.
• Ability to work a flexible work schedule (e.g. 24/7, weekend, holiday, on call availability).

• Performs pre-admission, admission, and continued stay reviews as directed per CMS guidelines, commercial payer guidelines, and/or hospital policy.
• Supports the values of service excellence, teamwork and integrity and maintains minimum standards for licensure and strives for personal/professional development.
• Maintains knowledge of the conditions of participation as it relates to utilization review and discharge planning.
• Maintains open communication with all appropriate parties while functioning as a liaison between ED physicians, hospitalists, attending physicians, and physician advisors.
• Leads the oversight and management of the functional and financial outcomes, including coordination and implementation of the discharge plan, during the acute-care hospitalization.
• Adapts behavior to the specific patient population, including respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions and communication style.
• Performs other related duties as required.

The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.

This…