LPN Case Manager

Ochsner Health Job Opportunity

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.

At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!

Job Title

This job coordinates, negotiates, procures and manages the care of complex patients to facilitate achievement of quality and cost outcomes for admission to the facility, diagnostic procedures, or clinical specialties. Serves as a resource for physician and multi-disciplinary team members to obtain information regarding current charges, reimbursement and payor source limitations.

Job Description

Education: Required Graduate of an accredited licensed practical nurse (LPN) program.

Work Experience: Required 3 years of hospital-based experience. Preferred - Experience in utilization review.

Certifications: Required Current licensed practical nurse (LPN) license in the state of practice.

Knowledge Skills and Abilities (KSAs):

• Working knowledge of admission criteria including, International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes and Medical Necessity guidelines.
• Computer skills and dexterity for data entry and retrieval of information.
• Effective verbal and written communication skills and ability to present information clearly and professionally.
• Proficient with Windows-style applications, various software packages specific to role and keyboard.

Job Duties

• Performs pre-admission, admission, and continued stay reviews as directed per content management system (CMS) or commercial payer guidelines and/or hospital policy.
• Collaborates with hospital staff, as required, for authorization/certification processes.
• Explores strategies to reduce length of stay and resource consumption for case managed patient populations.
• Identifies appropriate patients for the various third-party payor pre-certification or pre-authorization process.
• 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.

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 concerns.

The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.

Physical and Environmental Demands: The physical essential functions of this job include (but are not limited to) the following: Frequently exerting 10 to 20 pounds of force to move objects; occasionally exerting up to 100 pounds of force. Physical demand requirements are in excess of those for sedentary work. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.

Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid.

The incumbent has no occupational risk for exposure to communicable diseases.

Are you ready to make a difference? Apply Today!