Overview UNC Health Nash invites passionate healthcare professionals to join our team. Governed locally, we proudly serve a diverse patient base across Nash, Edgecombe, Halifax, Wilson Counties, and beyond. With a steadfast commitment to elevating community health through exceptional care, we prioritize excellence, compassion, and innovation, ensuring every individual receives the highest standard of support.
Joining our team means becoming an integral part of our dedication to wellness, where we constantly strive to redefine excellence in healthcare through state-of-the-art facilities and pioneering programs.
Summary Facilitates effective and cost-efficient care of patients through case management functions such as utilization review and discharge planning. May facilitate the execution of existing clinical pathways and may implement new clinical pathways. May follow the patient through the continuum of care, or focus on a specific aspect of case management. In collaboration with the Interdisciplinary Patient Care Team, coordinates the discharge plan when post-discharge home care, nursing home placement, rehabilitation facilities, or community services are involved.
Responsibilities Accesses cases to determine the most effective and cost-efficient model for care. Reviews assigned patients’ cases prior to, or upon admission, and determines the appropriate model for care. Recommends eligibility for pathways, protocols, or guidelines that could improve patient care and utilization of resources.
Performs concurrent and retrospective admission and continued stay reviews for private insurance, Medicare and Medicaid, in accordance with utilization review guidelines. Communicates impact days and offers more cost-effective alternative approaches when appropriate.
Determines frequency of patient reassessments according to identified needs and input from RN and MD. Serves as a resource for nursing staff related to psychosocial, mental health, and substance abuse patient care. Participates in the interdisciplinary plan of care. Collaborates with nursing staff regarding patient/family education and discharge planning needs.
Identifies and reports problematic DRGs, extended stay patients, frequent readmissions, or high-risk patients. Identifies and reports savings from early discharges. Identifies losses from extended stay and admission denials. Differentiates and reports internal, external, and patient/family origin for delayed discharges.
Serves as a patient/family resource and advocate to address questions, concerns, and needs promptly. Coordinates and documents placement of patients into residential or rehabilitative settings as needed, ensuring administrative requirements are completed in accordance with procedures and time frames.
Education Requirements Graduation from an accredited college with an Associate’s Degree in Nursing
Bachelor of Nursing Degree is preferred.
Licensure/Certification Requirements Current license to practice as a RN in North Carolina
Professional Experience Requirements None to 2 years of Hospital Case Management experience
Job Details Legal Employer: Nash Hospitals
Entity: Nash UNC Health Care
Organization Unit: NGH Case Management
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Assignment Type: Onsite
Work Schedule: Day Job
Location of Job: NASH HC
Exempt From Overtime: Exempt: No
Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.