Nurse Care Manager

Care Management Extender - AdultNew to OU Health? Ask your recruiter about our competitive wages and total rewards package, PLUS possible relocation assistance if you are located outside of 100 miles!These positions are available in levels 1,2,or 3 depending on experience, education, and licenses/certifications.The Case Management Extender (CME) provides non-licensed, clerical and administrative support to the RN and SW Case Managers to facilitate and execute plan of care and other related case management activities as needed. Duties include but are not limited to, calling or faxing information for patient care transitions, including SNF, Home Healthcare, Assisted Living, Outpatient Treatment Centers, etc. Assist with locating appropriate facilities for placement of patients moving to another level of care; facilitation of the transfer to alternate care facilities including arranging transport, facilitating referrals for home care services, and providing general administrative support; assist licensed case managers with regulatory requirements; scheduling post-discharge physician appointments.Essential ResponsibilitiesAssists RN/SW Care Manager in arranging care coordination needs.Assist RN/SW Care Manager by communicating with alternate level of care liaisons to identify an accepting facility and to establish a timeline for transfer.Arrange and/or assist with referrals for home care services.Ascertain resource and assist in making timely arrangements (ie transportation, food, lodging).Arrange or assist with durable medical equipment needs determined by hospital policy and physician order.Assist in scheduling appointments with providers such as PCP, Therapy, Specialist, diagnostic testing as needed.Maintain patient confidentiality of all communications and documents as required by hospital policy and as regulated by HIPPA.Enters data into multiple systems and submits appropriate information in a timely fashion to facilitate approval transition of care, i.e. PASRR, medication prior authorizations, etc.Issues patient correspondence to ensure compliance with regulatory requirements.Responds to inquiries, maintains and revises record keeping and filing systems; classifies, sorts, and files correspondence, articles, records, and other documents.Assists RN/SW Care Manager in arranging care coordination needs. Assists Case Manager in submitting PHI clinical information to facilities by fax or submitting clinical on payer portals.Maintain patient confidentiality of all communications and documents as required by hospital policy and as regulated by HIPPA.General ResponsibilitiesPerforms other duties as assigned.Minimum Qualifications (Level 1)Education: High School Diploma or GED required.Experience: 0-3 years of work experience required. 2 or more years of healthcare experience.License/Certification/Registration: Basic Life Support from the American Heart Association required.Minimum Qualifications (Level 2)Education: High School Diploma or GED required.Experience: 3 - 5 years of work experience required. 2 or more years of healthcare experience.License/Certification/Registration: Basic Life Support from the American Heart Association required.Knowledge/Skills/Abilities RequiredWorking knowledge of medical systems and medical terminology or complete department approved training within three (3) months of hire.Knowledge of CMS regulations, payment systems, post-acute care requirements or acquisition within 3 months of hire.Knowledge of third-party payer issues concerning reimbursement and regulatory perimeters or acquisition within 3 months of hire.In-depth understanding of typical insurance benefit plans regarding coverage or acquisition within 3 months of hire.Must be proficient with basic computer skills (word processing, excel spreadsheet, electronic fax.Excellent typing skills.Ability to work independently, manage time and prioritize patient needs.Able to work some weekends and holidays.Able to adapt to frequent changes in direction.Excellent interpersonal and communications skills with nursing staff, physicians, nurse practitioners and other health workers.Ability to meet deadlines and manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environments.Able to work in a dynamic, fast-paced team environment and to promote team concepts.Excellent verbal and written communication skills.Excellent interpersonal skills and ability to maintain composure in difficult situations.