Registered Nurse Case Manager Full Time Days

Description:

Positon Summary

The RN Case Manager is responsible for a) Follow up on patient accounts when authorization for stay is required , Fax numbers to Send clinical reviews b) Follow up on each account during the stay and on discharge for authorization - document in the electronic system, c) Escalate any potential disputes or denial of accounts to Director of Case Management or designee d) Trends disputed claims by at least payor and physician e) assist in obtaining authorization for patient discharged to Skilled Facilities or other post-acute care that require authorization f) other duties as assigned. Assisting with coordinating clinically complex patients care across a continuum; ensuring and facilitating the achievement of quality clinical and cost outcomes; negotiating, procuring and coordinating appropriate services and resources needed by the patient; and at key points, intervening to address and resolve issues/concerns. This individual is responsible for coordinating the clinical plan of care to conform to the evidence-based practice and regulatory requirements. This position integrates care coordination unitization management, and discharge planning.