RN Case Manager | Full Time | Chatuge Regional Hospital
Chatuge Regional Hospital
Job Description
Job Description
Job Description:
The primary purpose of this job is to do case management as well as social services activities - and utilization review duties.
Duties & Responsibilities may include - but not limited to:
1 - Complete chart reviews to:
* Assess medical necessity for the level of care and services provided using criteria as directed by the patient's payor sources
* Document in the UR note and complete certifications or forward information to payor's as required by payor source.
* Assist quality department in compliance with core measures.
* Improve concurrent documentation to optimize quality of patient care and accurate reimbursement.
* Participate in denial management and complete the appeals process.
2 - Assess discharge needs of patients, document in medical record, meet discharge needs, and participate in multidisciplinary team meetings.
3 - Utilize strategies to decrease re-admissions (complete risk assessments on inpatients, obtain referrals as needed, coordinate care with patient, family and doctor.
Education & Licensure:
Associates degree/Bachelor degree in Nursing - Licensed Registered Nurse (RN) - REQUIRED .
ACLS and BLS certifications. Two years Case Management experience - preferred.
Med/Surg background, Knowledge of Cerner and MCG (Indicia), and Case Management experience - preferred
Vacancy posted 10 days ago
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