Job Description
Serves as liaison between the patient and facility/physician. Ensures a
continuum of quality patient care throughout hospitalization and oversees
provisions for patient's discharge. Assesses, plans, oversees and evaluates the
appropriateness of care throughout admission and hospitalization of the patient.
Job Responsibility
- Facilitates patient management throughout hospitalization.
- Performs concurrent utilization management using evidence based medical
necessity criteria.
* Submits data to management regarding case management and/or quality
initiatives.
* Serves as an in-patient liaison - planning, assessing, implementing and
evaluating patient in collaboration with the health care team.
* Conducts chart review for appropriateness of admission and continued length
of stay; Facilitates throughput.
* Conducts clinical reviews and interacts with third party payers to obtain
approval of hospital days, pre-certification and post-discharge eligibility
in relation to clinical course.
* Ensures compliance with current state, federal, and third party payer
regulations.
* Documents the case management process in the medical record; completes and
documents a care coordination assessment on the patient.
* Serves as a liaison to patient, family, admitting, primary care physician,
health care team, and hospital departments.
* Completes applicable areas of the patients discharge instruction sheet and
the patient transfer sheet; ensures case management documentation is current
and accurate.
* Performs related duties as required. All responsibilities noted here are
considered essential functions of the job under the Americans with
Disabilities Act. Duties not mentioned here, but considered related are not
essential functions.
Job Qualification
* Graduate from an accredited School of Nursing. Bachelor’s Degree in Nursing,
preferred. Must be enrolled in an accredited BSN program within two (2) years
and obtain a BSN Degree within five (5) years of job entry date.
* Current License to practice as a Registered Professional Nurse in New York
State required, plus specialized certifications as needed.
*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of
potential base compensation that may be offered to a successful applicant for
this position at the time of this job advertisement and may be modified in the
future.When determining a team member's base salary and/or rate, several factors
may be considered as applicable (e.g., location, specialty, service line, years
of relevant experience, education, credentials, negotiated contracts, budget and
internal equity).
