RN Admissions Case Manager; UM- Concurrent and ED- OLGMC- PRN- Remote

Exceptional care starts with exceptional people.

For us, this is more than a job– it’s a calling. It’s waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you to discover your passion, reach your potential, and Pursue Your Purpose. Exceptional care starts with exceptional people and teams. Together we are leading the way.

This job is a registered Nurse who is able to determine the psychosocial, environmental, family economic dynamics that may affect the patient. This job confirms a clear, specific care setting order by the physician and applies hospital approved medical necessity criteria to review appropriate admissions, levels of care and continued stay. Documents completed reviews in the hospital approved data set and discusses, when appropriate, alternative care options with the ED, Admitting or Attending Physician.

Functions as the liaison and communicator with the patient, caregivers, multi-disciplinary team members as well as post-acute care and third party payers.

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
-Registered Nurse Diploma or equivalent

Required
-1 year of Hospital based experience in the delivery of patient care.

Experience functioning independently and working well within a team setting. Experience responding to change positively and working calmly as well as efficiently in high pressure situations.

Preferred
- Experience in Case Management or Utilization Review Business and Financial Knowledge as well as understanding of Health Care Delivery Systems

Required-Current RN License in the state of practice.

• Must have computer skills and dexterity required for data entry and retrieval of patient information.
• Must be proficient with Windows-style applications and keyboard.
• Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
• Excellent conflict resolution skills
• Ability to respond to change positively and work calmly, as well as efficiently in high pressure situations.
• Ability to function independently and work well within a team setting.
• Sense of objectivity, strong ethical principles, professionalism, sense of humor, strong work ethic, energy, and creativity

• Supports the values of Service Excellence, Teamwork and Integrity. Maintains minimum standards for licensure and strives for professional /personal development.
• Performs Pre-Admission, Admission and Continued Stay activities
• Maintains open communication with all appropriate parties.
• Manages aspects of the planning process in anticipation of the patient’s movement through the healthcare system.
• Proactively interacts with managed care/ third party payers to obtain financial certification, to appropriate reimbursement and minimize reimbursement denials.
• Manages the care of assigned patients through the healthcare system based on the patient’s individual needs.
• Additional duties as assigned.

Other related duties as required. The above statements describe the general nature and level of work only. They are not an…