Registered Nurse - Case Manager - PRN

This job is no longer active. View similar jobs.

POST DATE 8/30/2016
END DATE 11/5/2016

Christus Health Shreveport, LA

Company
Christus Health
Job Classification
Full Time
Company Ref #
5000133257206
AJE Ref #
576015571
Location
Shreveport, LA
Experience
Mid-Career (2 - 15 years)
Job Type
Regular
Education
Bachelors Degree

JOB DESCRIPTION

APPLY
Description







1. Assesses patients' clinical level of care needs to assure that the patient is receiving the right care, at the right time, by the right team, in the right location, to improve outcomes and decrease utilization of limited resources. Utilizes evidence-based medicine guidelines to drive care.



2. Rounds with medical staff, participates in planning patient stay/care daily.



3. Provides recommendation for appropriate clinical interventions working collaboratively with all health care team members.



4. Promptly identifies patient problems and barriers to care, which allows for proactive management. Actively identifies and proposes resolutions to clinical and/ or operational bottlenecks that impede progression of care.



5. Provides consultation and mediation services to nursing and physician staff to facilitate progression according to plan of care.



6. Identifies need for MD advisor and utilizes/consults as needed. Reports barriers to patient outcomes and recommends strategies to correct.



7. Reinforces and ensures appropriate patient education is carried out according to plan across continuum. Collaborates with/consults social workers to provide counseling to patients and families for complex placement issues.



8. Maintains working knowledge of and compliance with third party payer guidelines and provides education on same to other members of healthcare team.



9. Collaborates with clinical documentation specialist to ensure physician Medicare documentation is accurate and maximizes reimbursement potential.



10. Serves as a coach, mentor, and role model to all professional and support staff. Develops strong relationships with assigned physicians to provide consultation and recommendations for patient clinical care and desired outcomes.



11. Communicates/collaborates with all members of the healthcare and case management team to identify patient needs and formulate strategies to address barriers to care transitions.



12. Promptly enters avoidable day data and completes readmission analysis in a timely and accurate manner. Reports quality issues for follow-up. Identifies physician practice and process issues that impede patient progress through the acute care process.



13. Diligently monitors patient status, requesting changes from observation when needed based on LOS. Enters charges and hours for observation patients no later than the next business day of discharge..



14. Initiates the peer-to peer on concurrent denials to start the appeal process. Completes documentation for appeals process in a timely manner. Reports payor issues to department director when they are identified.



15. Collaborates with utilization review staff to identify barriers to patient progress, payor denials, or other concerns.

Requirements



Education/Skills

Registered Nurse with current Louisiana license prefer BSN or college degree in a related filed preferred.

Experience

Minimum of 5 years experience in a clinical role in a nursing field required. Demonstrated experience with at least 2 years experience in the key areas of responsibility. Desire excellent written and verbal communication skills. Proficient computer desktop skills required. Experienced with data analysis strongly preferred.

Licenses, Registrations, or Certifications

Registered Nurse with current Louisiana license prefer BSN or college degree in a related filed preferred.