NURSE CASE MGR-WKN ONLY-PRN, Ochsner Health System - New Orleans, LA
Duties
Registered Nurse or Licensed Practical Nurse with a diverse medical background, who is able to determine the psychosocial, environmental, family economic dynamics that may affect the patient. Functions as the liaison and communicator with the patient, caregivers, multi-disciplinary team members as well as post-acute care and third party payers. Confirms a clear, specific care setting order by the physician and applies hospital approved medical necessity criteria to review appropriate admissions, levels of care and continued stay. Documents completed review in the hospital approved data set. Discuss alternative care options with patient / caregivers as well as the multi-disciplinary team and assist with discharge planning needs. The Nurse Case Manager, utilizing the six essential components of case management, will facilitate, in collaboration with the multi-disciplinary team, movement along the health care continuum and as well as manage the patients health care benefits to ensure quality, cost –effective outcomes are achieved.
Requirements
Duties
Registered Nurse or Licensed Practical Nurse with a diverse medical background, who is able to determine the psychosocial, environmental, family economic dynamics that may affect the patient. Functions as the liaison and communicator with the patient, caregivers, multi-disciplinary team members as well as post-acute care and third party payers. Confirms a clear, specific care setting order by the physician and applies hospital approved medical necessity criteria to review appropriate admissions, levels of care and continued stay. Documents completed review in the hospital approved data set. Discuss alternative care options with patient / caregivers as well as the multi-disciplinary team and assist with discharge planning needs. The Nurse Case Manager, utilizing the six essential components of case management, will facilitate, in collaboration with the multi-disciplinary team, movement along the health care continuum and as well as manage the patients health care benefits to ensure quality, cost –effective outcomes are achieved.
Requirements
- 3 – 5 years hospital based experience in the delivery of patient care as a Registered Nurse (R.N.) or 6+ years of hospital based experience in the delivery of patient care as a Licensed Practical Nurse (L.P.N.).
- Hold a current valid Louisiana R.N. or L.PN license.
- Experience in Case Management, Utilization Review and / or Discharge Planning preferred.
- Certification in Case Management (CCM) or Certified Professional in Utilization Review, Utilization Management or Health Care Management (CPUR, CPUM, and CPHM) preferred.
- Must complete required Case Management Department specific training program including 5 core training sessions within the first 30 days of employment; Must review and be signed off on all applicable policies and procedures during first 30 days of employment; Successfully complete a Case Manager Competency Exam prior to performing duties without direct supervision and then annually thereafter to maintain competency to perform case management functions.
- Must maintain Nursing Licensure requirements for continuing education, Ochsner Health System required training as well as all OD & T training.
