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:
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- 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.