RN Case Manager

August 26, 2024 |

Department: Case Management

Status/Schedule: Full Time

Shift: Days

Location: Hartford, KY

For more information contact: Nicole Taylor, ntaylor@ochcares.com

Qualifications:

  • Education: 2 year degree or higher
  • Experience: Preferred
  • Additional Requirements:
    • Active KY Nursing License
    • Organized, telephone skills
    • Computer skills
    • Team player
    • Critical thinking, and great communication skills with patients and medical providers

Job Description:

    • 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.
    • Responds promptly to all referrals.
    • Attends regularly scheduled meetings.
    • Observes personal hygiene and dress code as outlined in the Ohio County Healthcare personnel policies.
    • Is accountable for ensuring patient safety during the course of performing all duties.
    • Schedules and notifies all disciplines, patients and their families of Swing Bed Care Conferences.
    • Facilitates and documents all Swing Bed Care Conferences.
    • Participates in New Employee Orientation to educate on abuse and neglect.
    • Actions are consistent with Ohio County Healthcare’s purpose, vision, and values.
    • Adheres to Ohio County Healthcare’s legal and compliance program.
    • Early identification and notification of KODA if applicable.
    • Understanding of role in emergency situations in the facility.
    • Demonstrates an understanding of Policy Tech and OCH Common Drive.
    • Demonstrates an understanding of Nex-Talk Interpreting Services.
    • May be requested to be member of QI team.
    • Frequently accesses email to stay up to date on information within the organization and provides a way of communication between staff members.
    • Involvement in the emergency department to help facilitate appropriate admission, discharges and transfers.
    • Assistance with reporting data as applicable as specific roles and responsibilities.

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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