Performs pre-admission, admission, and continued stay reviews as directed per CMS guidelines, commercial payer guidelines, and/or hospital policy.
Supports the values of Service Excellence, Teamwork, and Integrity, maintains minimum standards for licensure, and strives for personal/professional development.
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.
Adapts behavior to the specific patient population, including respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions and communication style.
Qualifications
Education – Registered Nurse Diploma or equivalent.
Experience – 3 years hospital-based experience; preferred experience in discharge planning, case management, or utilization review.
Certifications – Current state of Louisiana Registered Nurse license; Basic Life Support (BLS) from the American Heart Association; preferred certification in Case Management (CCM) or Accredited Case Manager (ACM).
KSA’s – Computer skills and dexterity required for data entry and retrieval of patient information; proficiency with Windows-style applications and keyboard; effective verbal and written communication skills and the ability to present information clearly and professionally; strong interpersonal skills.
Ochsner 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.