ER Case Manager

March 24, 2023 |

Department: Case Management

Status/Schedule: Full Time

Shift: Days

Location: Hartford, KY

For more information contact: Michelle Hickerson,


  • Education: RN required; BSN preferred
  • Experience: Previous acute care experience; previous case management experience
  • Additional Requirements: Experience with E-Clinical Works a plus

Job Description:

  • Implementation of CM in the ER.
  • Work with ER physicians and hospitalists to screen for admission criteria
  • Utilization of InterQual criteria to determine appropriate level of care, facilitate necessary transfers out of ER
  • Referrals to community resources as needed including home health and nursing home placement, and aid hospitalist staff in relation to admission of patients.
  • Admission reviews for both federal and non-federal patients utilizing approved criteria.
  • Conducting continued stay reviews for both federal and non-federal patients utilizing approved criteria.
  • Application of Condition Code 44 per CMS guidelines.
  • Demonstrates knowledge of various levels of care offered in the facility. These include the following: Acute/Inpatient, Observation, Outpatient Surgery Observation, Swing Bed, Critical Care and IVT.
  • Demonstrates effective critical thinking skills and problem solving with difficult patient situations to foster positive outcomes.
  • Maintains all required documentation and retention of records as outlined in facility policies.
  • Identification of potential abuse and neglect and compliance with reporting standards.
  • Demonstrates knowledge of regulatory standards that apply to the area of practice in Case Management.
  • Effective communication with staff, physicians, patients, families and visitors and all community agencies.
  • Performs admission assessments on patients of Ohio County Healthcare and initiates discharge planning at the point of assessment. Risk assessment performed for potential environmental hazards to patient.
  • Assessment of all Private Pay patients and assistance with resource navigation.
  • Understands and maintains compliance with the MOON notice per CMS guidelines.
  • Understands and maintains compliance with the Important Message from Medicare per CMS guidelines.
  • Understanding of Medical necessity precertification process for outpatient infusion and injection patients.
  • Maintains strong working relationships with Community Health, Welfare and Social agencies.
  • Participates in opportunities for continuing education and professional self-development.
  • Maintains a current license in the state of Kentucky.
  • Assures proper and timely documentation in patient medical records.
  • Serves as a liaison between Ohio County Healthcare and community agencies on behalf of the patient to provide continuity of care after facility discharge.
  • Maintains confidentiality in all patient records and interactions.

Ohio County Healthcare

Ohio County Healthcare is a non-profit Joint Commission accredited health system which provides a wide range of hospital, primary care and specialty physician services.

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Ohio County Healthcare offers a broad range of healthcare across a diverse landscape.

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