RN, Case Manager

UofL Health

  • Louisville, KY
  • Permanent
  • Full-time
  • 1 month ago
OverviewWe are Hiring atLocation:Shift Options: Full Time, FirstAbout UofL HealthUofL Health is a fully integrated regional academic health system with eight hospitals, four medical centers, Brown Cancer Center, Eye Institute, nearly 200 physician practice locations, and more than 1,000 providers in Louisville and the surrounding counties, including southern Indiana. Additional access to UofL Health is provided through a partnership with Carroll County Memorial Hospital.With more than 13,000 team members – physicians, surgeons, nurses, pharmacists and other highly-skilled health care professionals, UofL Health is focused on one mission: to transform the health of communities we serve through compassionate, innovative, patient-centered care.ResponsibilitiesUnder the direction of the Manager or Director of Care Coordination or CNO, the RN Case Manager performs activities which support the Care Coordination Department including:Promotes optimal management of clinical resources by conducting timely initial admission assessments based on clinical indicators and anticipated service needs for appropriate level of hospital care; Validates patient demographics and payor sourceUtilizes and contributes to the development of the multidisciplinary clinical assessment of patients on an on-going basis during the patient’s admission to ensure the quality and appropriateness of patient careImplements, reassesses, and evaluates patient condition and coordinates plan of care daily; Develops patient specific plan of care based on the individual needs of the patients, conversations with providers and other staff, and documentation in electronic medical record (EMR.) Ensures updated plan of care is documented in the EMRCoordinates the discharge needs of patients with necessary internal and external providers while protecting patient informationPerforms timely, professional, and appropriate documentation as reflected in the Quality Review Audit processAdvocates for patient/family needs in a respectful, non-judgmental, and confidential mannerServes as a liaison or facilitator for the patient and interdisciplinary healthcare team in the management of unusual or questions cases. Educates the healthcare team about the role of the RN: Case Manager. Is accessible to the healthcare team as a resource.Appropriately refers cases to manager/director of care coordination, CAO, or medical director when intensity of service or severity of illness is not present and is unable to be resolvedEnsure delivery of Discharge Medicare Important Message (IM) and Medicare Outpatient Observation Notice (MOON), where applicableAcknowledges, addresses, and completes are Consults to Case Management on respective units in EMROther Functions:Works collaboratively with social workers to identify social and financial barriers and community resourcesCompletes referrals to Social Worker for patients with high-risk indicatorsAttends monthly departmental staff communications meetings. Serves as an active member of committees, as needed, which may include a variety of projects or topicsEnhances professional growth and development through participation in educational programs, reading current literature, attending in-service meetings and workshops that are related to assigned areas of responsibility. Assumes responsibility of growth and development, maintains competency in care management principlesEducates physicians, patients, and staff with regards to payors, financial issues, documentation, and potential compliance issuesServes as a resource to physicians for clinical management and financial issues. Assists the providers with promoting efficiencies in the care delivery system and reducing/ eliminating barriers to efficient/effective serviceMaintains compliance with all company policies, procedures and standards of conductComplies with HIPAA privacy and security requirements to maintain confidentiality at all timesPerforms other duties as assignedQualificationsRequired Qualifications
  • Licensed or eligible for license in Kentucky
  • Basic Life Support (BLS) accredited by the American Heart Association (AHA)
  • Bachelor’s degree from accredited college or University or RN with a Bachelors Degree in Business or Health Care Administration preferred. Will consider RN with A.D.N. if actively pursuing BSN, with BSN completion required within 2 years of hire.
  • Must have 2-3 years experience as an RN plus utilization management or discharge planning/case management experience. Minimum two years experience performing utilization review and/or quality assurance activities in an acute care facility or HMO/PPO/PRO preferred. Must be able to adjust priorities quickly, organize multiple tasks simultaneously, and work interdependently with many levels of staff. Attention to detail; strong organizational, interpersonal and communication skills; and innovative problem solving skills required. Must be able to adjust work hours depending on depending upon departmental needs as determined by the director or manager.
Preferred Qualifications
  • Certification in a nursing specialty area or CCM
Benefits & Perks
  • Competitive Pay & Benefits Options
  • Paid Vacation, Sick days, and Holidays
  • Free tuition to UofL for Part- and Full-time employees for Child/Spouse/Domestic Partner
  • 401K with Employer Match
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UofL Health