RN Case Manager- OLG Region Case Management- PRN at Ochsner Health System in Acadiana Region, LA

Job description

Exceptional care starts with exceptional people. For us, this is more than a job– it’s a calling. It’s waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you to discover your passion, reach your potential, and Pursue Your Purpose. Exceptional care starts with exceptional people and teams. Together we are leading the way. This job handles multi-disciplinary communications and facilitations of care throughout a patient’s hospitalization, which includes a review of the appropriate utilization of resources, balanced with the patient’s right to self-determination. Reviews patient hospitalizations, recommends a level of care that meets medically necessary hospital care criteria, and confirms a clear, specific level of care order and other appropriate documentation in the medical record. May discuss alternative care options with the Emergency Department (ED) physician or attending physician. Works as a liaison and communicates with the patient, caregiver, multi-disciplinary team members as well as post-acute and third-party payers. Collaborates with the care team to develop and implement discharge plans based on patient’s individualized needs. OLG Region support for case management Education Required - Graduate of an accredited school of nursing. Preferred - Bachelor’s degree in nursing. Work Experience Required - None. Preferred - 3 years of hospital-based experience in discharge planning, case management or utilization review. Certifications Required - Current registered nurse license in state of practice. Basic Life Support (BLS) from the American Heart Association. Preferred - Certification in Case Management (CCM) or Accredited Case Manager (ACM). Knowledge Skills and Abilities (KSAs) Proficiency in using computers, software, and web-based applications. Effective verbal and written communication skills and ability to present information clearly and professionally to varying levels of individuals throughout the patient care process. Strong interpersonal skills. Ability to work a flexible work schedule (e.g. 24/7, weekend, holiday, on call availability). Job Duties Performs pre-admission, admission, and continued stay reviews as directed per CMS guidelines, commercial payer guidelines, and/or hospital policy. Supports the values of service excellence, teamwork and integrity and maintains minimum standards for licensure and strives for personal/professional development. Maintains knowledge of the conditions of participation as it relates to utilization review and discharge planning. Maintains open communication with all appropriate parties while functioning as a liaison between ED physicians, hospitalists, attending physicians, and physician advisors. Leads the oversight and management of the functional and financial outcomes, including coordination and implementation of the discharge plan, during the acute-care hospitalization. Adapts behavior to the specific patient population, including but not limited to respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions and communication style. Performs other related duties as required. The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time. Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related c