*Request for accommodations in the hire process should be directed to UMC Human Resources.*
Benefits
Health insuranceFlexible schedule
Additional Information
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Registered Nurse (RN) - Case Manager I
Full Time
Weekends: Sat, Sun, Mon (12 hour shifts with flexible start times)
Case Management functions throughout majority of inpatient units within University Medical Center as well as the Emergency Center. Case Management works closely with Social Services. The attention to detail a nurse can provide along with a strong clinical training are critical components for the Case Manager at UMC. Our focus is Utilization Review with some discharge planning and coordination of care for patients. Our purpose is to provide high quality care through appropriate resource allocation, to assure effective and efficient utilization of hospital facilities and services, and help facilitate improving maximum financial strength.
Job Summary:
-Screen admissions each day to identify appropriate level of management
required for each patient for the service area covered.
- Review new admissions, applying
medical necessity
criteria, and develop an anticipated discharge date for the assigned
units/rooms.
-Prepares to discuss patients with length of stay greater than 20 days and
difficult discharges
with the Managed Care Committee members on Wednesdays.
- Assist and facilitate coordination of comprehensive, individualized plan of
care in collaboration
with interdisciplinary team.
-Utilize CCM for documentation of Reviews, Appropriateness of admission
and continued stay,
Avoidable days, Denials, Interdisciplinary communication.
- Monitor and facilitate appropriate utilization of resources.
- Perform review functions for appropriateness of admission and continued
hospital stay using
Cerner Care Management (CCM)/InterQual criteria.
Works with Emergency Room staff to facilitate transfer of patients needing
to appropriate facilities.
- Work with Emergency Room Staff to develop strategies to decrease
Emergency Department use
by individuals identified as "frequent users" and to find community
resources for these patients.
- Lead unit huddles (per unit guidelines) with Social Services to discuss
discharge needs/ barriers
and anticipated discharge dates.
- Collaborate with the interdisciplinary team to formulate a safe, efficient
discharge plan based on
the patient's needs and payer requirements.
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