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RN Case Manager PR#2007
Position: Case manager
Position type: Part Time
St. Luke's Hospital in Columbus, NC is seeking to add a RN case manager.
Performs the primary functions of an RN in assisting, planning, implementing and evaluating the care of all assigned patients. Must be able to translate MD orders into nursing care. Must be knowledgeable in concurrent coding, DRG assignment. Queries MD regarding patient's plan of care and additional documentation to support Medicare admission criteria. Performs insurance and Medicaid reviews and updates as required. Obtains in-patient re-certification. Communicates effectively with all disciplines to ensure proper patient follow-up and discharge planning. Participates in hospital billing committee and Utilization Review Committee. Assists in reviewing admissions for Swing Bed using appropriate InterQual Criteria. Is the back up call for Utilization Review. Performs general nursing duties in all departments with adequate supervision.
-Coordinates patient care with all disciplines.
-Performs insurance reviews, initial reviews and updates as required.
-Have knowledge of medications and their correct administration based on age of the patient and their clinical condition.
-Queries MD and nurses regarding patient needs and documentation.
-Treats patients and their families with respect and dignity. Identifies and addresses psychosocial, cultural, ethnic, religious/spiritual needs of patients and their families. Functions as liaison between administration, patients, physicians and health providers.
-Interacts professionally with patient/family and involves patient/family in the formation of the plan of care.
-Demonstrates knowledge of the principles of growth and development over the life span and the skills necessary to provide age appropriate care to the patient population served. Is able to interpret data about the patient's status in order to identify each patient's age specific needs and provide necessary care.
-Assists with Medicare re-certification on Swing Bed patients.
-Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's needs.
-Assists in the review and evaluation of data, determining the presence or absence of opportunities for improvement of care.
-Assists in the admission process for applicants to the facility.
-Demonstrates an ability to be flexible, organized and function under stressful situations.
-Is knowledgeable of criteria for Medicare, Medicaid, HMO and private insurance companies.
-Communicates daily with personnel regarding admissions and discharges to various units.
-Assists the Discharge Planner, when needed, to communicate with family members and caretakers regarding the needs of the patient and anticipated plans.
-Is knowledgeable of the patient's financial status, diagnosis and discharge needs.
-Maintains a good working relationship both within the department and with other departments.
-Works at maintaining good rapport and a cooperative working relationship with physicians, departments and staff.
-Actively participates in performance improvement and continuous performance improvement (CQI) activities.
Required Knowledge, skills and abilities:
1. Graduate of an accredited school of nursing.
2. Current State Registered Nurse Licensure, within state of practice.
3. Current BCLS certification.
4. Experience in providing patient care.
5. Able to communicate effectively in English, both verbally and in writing.
6. Additional languages preferred, but not required.
7. Strong written and verbal skills.
8. Basic computer knowledge.
9. Appropriate communication skills.
10. For physical demands of position, including vision, hearing, repetitive motion and environmental, see following description. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising client care
Special Instructions to Applicants: Background check and drug screenings are required for new team members.
Position Type : Part Time
Shift : Day
Ref Code: 2007
101 Hospital Drive
Columbus, NC 28722