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RN Case Manager

Company: TTS technologies
Location: Royston
Posted on: April 10, 2021

Job Description:

-- Facilitate team meetings that foster interdepartmental collaboration with the patient and their family as deemed necessary, this includes multidisciplinary meetings and Utilization Review/Case Management meetings. Provides input in such meetings regarding utilization management and discharge planning. -- Responsible for evaluating and screening potential admissions to the facility when appropriate. -- Knowledgeable of criteria for Medicare, Medicaid, HMO and private insurance coverage. -- Initiate ongoing communication with the patient and patient's family to assess discharge needs. -- Communicate with physicians to ascertain their plans for a timely discharge. -- Document discharge planning as an ongoing review. -- Responsible for home care needs being met by the time of discharge, with a goal of arrangements completed 24 hours prior to discharge when date of discharge is known. -- Cooperate with insurance companies, based on information received. -- Manage and collaborate with the healthcare team on Swing Bed placement and complete MDS documentation as necessary. -- Ensures that a quality of care is maintained or surpassed by collecting quality indicators and variance data and reporting the data to the appropriate department; reports and identifies data that indicates potential areas for improvement of care and services provided within the system. -- Assist as needed with obtaining referrals, prior authorization for SNF, acute rehab and appointments. -- Educates physicians and staff regarding appropriate level of care/utilization issues. -- Develop and implement methods, policies and procedures to improve the departments' efficiency and overall effectiveness. -- Oversight and evaluation of the discharge planner/ utilization review nurse. -- Perform and oversee needs analysis and planning. Work with executive leadership to ensure targets are met for the annual operating plan/financial management. Job Requirements:Qualifications:-- RN with current state licensure (Ga)-- At least 3 years nursing experience-- Case Management experience required-- Ability to communicate effectively in written, oral or electronic format

Keywords: TTS technologies, Athens , RN Case Manager, Executive , Royston, Georgia

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