Emergency Department Case Manager

Recruiter
Altru Health System
Location
Grand Forks
Salary
Competitive
Posted
20 Feb 2021
Closes
24 Feb 2021
Job role
Accountant
Sector
Healthcare
Contract type
Permanent
Hours
Full time
Job Summary The ED Case Manager reviews patients and coordinates with rest of ER team regarding appropriateness for admission and completes utilization review as appropriate to assist physician in determining level of care. The ED Case Manager will assist with discharge planning needs and coordination of the discharge plan for those patients going home as appropriate. Will collaborate with treatment team managing ED patient to manage / develop care plans as needed. Essential Job Functions Prioritizes patients in the Emergency Department and proactively completes Utilization Review. Reviews medical necessity of patients noted as "hospital stay needed." Monitors trends for staff/provider educational opportunities as it relates to status management processes. Communicates with medical staff, coordination team and nursing staff regarding appropriateness of admission and/or need for continued stay along with the discharge plan. Assesses the patients to identify clinical needs, issues, financial factors, available reimbursement, care goals, discharge and continuing care options. Collaborates with ED nurse/ED charge nurse to establish discharge planning needs consistent with the overall outcomes/goals and assists with the discharge planning process for those patients going home with identified resources. Communicates with community resources. Ensures that patient care plans are being followed and that the appropriate services are administered to avoid inappropriate admissions. Provides information and referrals to patients/families regarding resources and services i.e. insurance coverage, equipment, home health, outpatient social work, etc. Addresses frequent ED utilization to ensure care plans are in place and followed by care team. Provides education to patient and family about appropriate use of ED services. Assists the system with insurance verification and reimbursement issues as required and obtains any necessary precertification for care within the continuum for community care. Performs other duties as assigned or needed to meet the needs of the department/organization. License, Certification & Registration Registered Nurse–North Dakota Board of Nursing (NDBON) or Compact State Agreement –Prior to Start Date Registered Nurse– Minnesota Board of Nursing –Within 2 Months of Start Date Basic Life Support (BLS) –American Heart Assoc.–Within 2 Months of Start Date ExperienceA minimum of 3 years of related/Nursing experience –Required

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