Case Manager RN

Job description

Department: Case Management Schedule/Status: 8:00am-4:30pm; Full Time Standard Hours/Week: 40: GENERAL DESCRIPTION: Under the general supervision of the Director, Case Management is responsible for the management and coordination of total plan of patient care from the point of admission to the point of discharge. Patient case management includes utilization review for appropriateness and efficiency, initial assessment and planning for discharge needs. The position shall exemplify the desired Culture of Choice® and philosophies of Parrish Healthcare. KEY RESPONSIBILITIES: - Assesses and evaluates the patient’s plan of care within 24 hours of admission and at least every 96 hours utilizing Milliman criteria determining appropriate patient status that coincides with 2MN rule and medical necessity of hospital admission. - Documents and conveys appropriate information regarding patient’s admission and continued hospitalization to various payors for authorization and reimbursement purposes. - Collaborates and makes referral to physician advisor when unable to resolve issue with attending physician. - Meets with patient and/or family/personal representative as soon as possible, but not gr...