Case Manager (RN) - Full-Time

Summary of Duties

Affords care that effectively manages adult and geriatric patients. Conducts utilization reviews for medical necessity and implements discharge planning.

Essential Job Functions

• Implements case management services to meet patient/family/significant other needs.
• Demonstrates adherence to appropriate length of stay and resource utilization standards.
• Makes referrals to physician advisors when necessary.
• Conducts systematic discharge planning assessments and collaborates with interdisciplinary teams.
• Communicates with referral sources to support discharge planning and ensures patient consent documentation.
• Aids in the timely completion of patient care across the continuum by assisting with physician orders.
• Administers and conducts Patient Perception Survey process.
• Identifies and reports opportunities to improve patient care, including managing complaints and unusual care issues.
• Ensures accurate utilization review monitoring and documentation of medical necessity.
• Collaborates in the coordination and utilization of resources throughout the patient's hospitalization.
• Manages patient stays to achieve in-window discharges.
• Performs pre-admission assessments and medical necessity evaluations, writing admission orders when necessary.
• Updates coding specialist on changes to patients' conditions affecting DRG assignments.
• Facilitates physician queries and documentation.

Education & Experience

• Current nursing license in the State of Alabama required.
• Bachelor of Science in Nursing (BSN) preferred.
• Minimum of three (3) years experience in nursing required.
• Minimum of two (2) years experience in an acute care hospital setting preferred.