Oct 24, 2020

RN Case Manager PRN

  • Ardent Health Services
  • Tulsa, OK, USA

Job Description

Job Description

Who We Are

Hillcrest HealthCare System (HHS) is a comprehensive health system with approximately 5,000 employees that serves the communities of eastern Oklahoma. HHS includes nine hospitals throughout Eastern Oklahoma, the Oklahoma Heart Institute, and Utica Park Clinic.

Hillcrest Hospital South is a 180 bed acute care hospital with a history of providing state-of-the-art technology in a friendly, community setting that is easy to navigate. With more than 1000 employees and 700 physicians, we provide a wide range of inpatient and outpatient services for all ages including emergency, intensive care, stroke, cardiology, maternity, orthopedics and surgery.

We welcome you to take the next step to join our highly skilled team of health care professionals who value Our Way of Changing Lives with Respect, Compassion, Responsibility and Accountability.

What You’ll Do

Responsible for providing case management services to patients and families. Primary duties include discharge planning and transitions of care. The case manager demonstrates the ability to assess, coordinate, plan, monitor, implement and evaluate the patient’s plan of care while ensuring and facilitating the achievement of optimal quality, clinical and financial outcomes. Monitors physician documentation and works closely with the medical staff to assign the patient to the appropriate level of care. Responsible for the initial utilization review screen and the ongoing utilization review process through discharge. Identifies patient discharge and transition of care needs and is ultimately responsible for the coordination of the discharge planning activities. Works collaboratively with the patient and interdisciplinary team to develop a safe discharge plan that minimizes the risk of hospital readmissions. Actively participates in quality improvement and evaluation processes.

  • Utilization Management - Able to perform utilization review on assigned patient population and determine appropriate status of patients (inpatient versus observation). Demonstrates the ability to accurately process a Code 44 following hospital policy. Reviews all Medicare 1 day stays to insure appropriate status. Charts all U.R. activities accurately in Midas i.e.: E.H.R. referrals, avoidable days, concurrent review, and observation review. Attends rounds with Physician Advisor and provides clinical updates during rounding process.
  • Discharge Planning - Demonstrates the ability to coordinate a safe and adequate discharge planning with the patient/family, physician and hospital staff. The discharge process is initiated as soon as possible after admission. The elements of the discharge plan are shared with the patient/family throughout the stay. Documentation of all discharge planning efforts is appropriately documented in the patient’s medical record. Post discharge calls are made to patients when appropriate.
  • Coordination of Care/Preventing Readmissions - Appropriately coordinates care transitions to LTAC’s, SNF, Home Health, Hospital to Hospital, Inpatient Psychiatric Units etc… Insures medical records and pertinent information is sent to receiving agency for a safe transfer process. Arranges PCP follow-up appointments, insures patients can obtain post hospital medications, addresses patient transportation needs before discharge.
  • Compliance - Demonstrates an understanding and follows Medicare and hospital compliance standards i.e.: CMS 2 midnight rule attestation, Important Message from Medicare, Code 44, handling a discharge appeal for a Medicare beneficiary etc…
  • Values - Promotes a positive atmosphere in the workplace through positive personal attitudes, behavior, relationships and communications. A leader by example; conveys professionalism, courtesy and respect for others at all times. Is motivated to care for and serve others by being a sincere and active participant in positive relationships in light of conflict. Accomplishes tasks and responds to the requests of others with a sense of urgency. Exhibits desire/ability to collaborate and actively participate as a positive contributor to the team.

What You’ll Bring

  • Graduate from an accredited nursing program. BSN preferred, CCM preferred.
  • BLS for Healthcare Providers.
  • Superb customer service, telephone and communication skills. Ability to work independently with minimal supervision. Demonstrates sound clinical knowledge of the medical surgical patient. Excellent organizational and prioritization skills. Possess basic computer skills. Demonstrates knowledge of Microsoft Office, Microsoft Word, Excel, and Power Point.
  • Minimum of 5 years of Medical Surgical Nursing. Case Management experience required.
  • Current Oklahoma nurses licensure.

What We Offer

  • Competitive pay 
  • Medical, dental, and vision insurance 
  • 401k with Company match 
  • Company paid basic life insurance and long term disability coverage 
  • Generous paid time off, including an additional extended illness bank 
  • Tuition Reimbursement 
  • Advancement and career development opportunities