Owensboro Medical Health System Owensboro , KY 42302
Posted 4 weeks ago
Job Summary Facilitates cost-effective, quality patient outcomes and transitions by determining the appropriate level of care and providing guidance, education, and support to assigned patients. # Job Responsibilities Assessment of complete chart and knowledge of patient#s medical condition, financial status, emotional needs, and support systems. Conducts initial and concurrent reviews of clinical documentation for medical necessity and appropriate level of care using approved criteria within specified time frame. Provides appropriate clinical information to payers as requested within specified time frame. Collaborates with the Attending Physician, Physician Advisor, Director, Manager, or Supervisor of Case Management on patients who are not meeting the regulatory requirements for hospitalization and delays in services and/or discharge. Delivers regulatory letters to patients as needed. Works in collaboration with the interdisciplinary team to ensure quality support of care and resource information May assist patients/families with referrals to community agencies, post-acute providers, and/or provide education and resources. Provides education and acts as a resource for physicians, staff, and patients/families regarding case management processes. Trains new case managers, students, and interns as needed. Qualifications Associate#s degree or higher in Nursing required upon hire AND Bachelor#s degree or higher in Nursing required within 5 years of employment in this position No experience required RN - Licensed as a Registered Nurse. Eligible to practice nursing in the State of Kentucky required upon hire Skills and Attributes Requires critical thinking skills and decisive judgment. Works under minimal supervision. Must be able to work in a stressful environment and take appropriate action. Physical Demands Standing: Frequently Walking: Frequently Sitting: Frequently Lifting 0-25 lbs: Frequently Lifting 25-75 lbs: Rarely Lifting over 75 lbs: Rarely Carrying 0-25 lbs: Frequently Carrying 25-75 lbs: Rarely Carrying over 75 lbs: Rarely Pushing/Pulling 0-25 lbs: Frequently Pushing/Pulling 25-75 lbs: Frequently Pushing/Pulling over 75 lbs: Frequently Climbing: Occasionally Bending/Stooping: Frequently Kneeling: Occasionally Crouching/Crawling: Occasionally Reaching: Frequently Talking: Frequently Hearing: Frequently Repetitive Foot/Leg Movements: Rarely Repetitive Hand/Arm Movements: Frequently Keyboard Data Entry: Frequently Running: Occasionally Vision: Depth Perception: Frequently Vision: Distinguish Color: Frequently Vision: Seeing Far: Frequently Vision: Seeing Near: Frequently Owensboro Health Core Commitments INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers. RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community. TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future. INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health. SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do. EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service.
Job Summary
Facilitates cost-effective, quality patient outcomes and transitions by determining the appropriate level of care and providing guidance, education, and support to assigned patients.
Job Responsibilities
Assessment of complete chart and knowledge of patient's medical condition, financial status, emotional needs, and support systems.
Conducts initial and concurrent reviews of clinical documentation for medical necessity and appropriate level of care using approved criteria within specified time frame.
Provides appropriate clinical information to payers as requested within specified time frame.
Collaborates with the Attending Physician, Physician Advisor, Director, Manager, or Supervisor of Case Management on patients who are not meeting the regulatory requirements for hospitalization and delays in services and/or discharge.
Delivers regulatory letters to patients as needed.
Works in collaboration with the interdisciplinary team to ensure quality support of care and resource information
May assist patients/families with referrals to community agencies, post-acute providers, and/or provide education and resources.
Provides education and acts as a resource for physicians, staff, and patients/families regarding case management processes.
Trains new case managers, students, and interns as needed.
Qualifications
Associate's degree or higher in Nursing required upon hire AND
Bachelor's degree or higher in Nursing required within 5 years of employment in this position
No experience required
RN - Licensed as a Registered Nurse. Eligible to practice nursing in the State of Kentucky required upon hire
Skills and Attributes
Requires critical thinking skills and decisive judgment.
Works under minimal supervision.
Must be able to work in a stressful environment and take appropriate action.
Physical Demands
Standing: Frequently
Walking: Frequently
Sitting: Frequently
Lifting 0-25 lbs: Frequently
Lifting 25-75 lbs: Rarely
Lifting over 75 lbs: Rarely
Carrying 0-25 lbs: Frequently
Carrying 25-75 lbs: Rarely
Carrying over 75 lbs: Rarely
Pushing/Pulling 0-25 lbs: Frequently
Pushing/Pulling 25-75 lbs: Frequently
Pushing/Pulling over 75 lbs: Frequently
Climbing: Occasionally
Bending/Stooping: Frequently
Kneeling: Occasionally
Crouching/Crawling: Occasionally
Reaching: Frequently
Talking: Frequently
Hearing: Frequently
Repetitive Foot/Leg Movements: Rarely
Repetitive Hand/Arm Movements: Frequently
Keyboard Data Entry: Frequently
Running: Occasionally
Vision: Depth Perception: Frequently
Vision: Distinguish Color: Frequently
Vision: Seeing Far: Frequently
Vision: Seeing Near: Frequently
Owensboro Health Core Commitments
INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers.
RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community.
TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future.
INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health.
SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do.
EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service.
Owensboro Medical Health System