Case Manager (RN)

Job description

Overview The Case Manager leads care coordination throughout hospital levels of care. In this role the Case Manager completes assessments and transition care planning that reflects the wishes and needs of the patient and their family. This position also assists physicians and finance with the management of resource utilization through the use of medical necessity criteria. Responsibilities: Completes medical necessity criteria for both inpatient and outpatient visits, documenting the reasons when the patient status is not supported in the database and reporting discrepancies during weekday morning huddles. Completes assessments and discharge plans for inpatients. Provides consultation for outpatient and observation patient stays when requested. Assists with discharge planning for these patients as needed. Builds provider networks and community resources and provides updates to the clinical team. Assists in the case management functions of the preoperative preparation and discharge planning for Inpatient or outpatient surgeries, specifically the Total Joint Program as able. Leads morning huddles focusing on patient status, expected LOS and providing the tentative plan for discharge....