Overview We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.
At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!
Responsibilities This job handles multi-disciplinary communications and facilitation of care throughout a patient’s hospitalization, including a review of resource utilization balanced with the patient’s right to self-determination. Reviews patient hospitalizations, recommends a level of care that meets medically necessary hospital care criteria, and confirms a clear, specific level of care order and other appropriate documentation in the medical record. May discuss alternative care options with the Emergency Department physician or attending physician. Acts as a liaison and communicates with the patient, caregiver, multi-disciplinary team members, post-acute and third-party payers. Collaborates with the care team to develop and implement discharge plans based on patient’s individualized needs.
Performs pre-admission, admission, and continued stay reviews as directed per CMS guidelines, commercial payer guidelines, and/or hospital policy. Maintains knowledge of the conditions of participation as it relates to utilization review and discharge planning. Maintains open communication with all appropriate parties while functioning as a liaison between ED physicians, hospitalists, attending physicians, and physician advisors. Leads the oversight and management of the functional and financial outcomes, including coordination and implementation of the discharge plan, during the acute-care hospitalization. Performs other related duties as required.
Qualifications Education
Required — Graduate of an accredited school of nursing. Preferred — Bachelor’s degree in nursing.
Work Experience
Required — None. Preferred — 3 years of hospital-based experience in discharge planning, case management or utilization review.
Certifications
Required — Current registered nurse license in state of practice. Basic Life Support (BLS) from the American Heart Association. Preferred — Certification in Case Management (CCM) or Accredited Case Manager (ACM).
Knowledge, Skills and Abilities (KSAs)
Proficiency in using computers, software, and web-based applications.
Effective verbal and written communication skills and ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
Strong interpersonal skills.
Ability to work a flexible work schedule (e.g., 24/7, weekend, holiday, on call availability).
Physical and Environmental Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Medium Work – exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects. (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Note: The constant stress and strain of maintaining a production pace can be physically demanding.
Duties performed routinely may involve exposure to blood, body fluid and tissue. The incumbent works in a patient care area and may be exposed to hazards in the healthcare environment.
Equal Opportunity and Other Notices The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status. Ochsner Health does not engage in discriminatory hiring practices and complies with applicable laws and regulations.
Are you ready to make a difference? Apply Today!
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Please refer to the job description to determine whether the position is remote or on-site. Individuals who reside in the following areas are not eligible for remote work: Colorado, California, Hawaii, Illinois, Maryland, Minnesota, New Jersey, New York, Vermont, Washington, and Washington D.C.
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