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.