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!
This job handles multi-disciplinary communications and facilitation of care throughout a patient’s hospitalization, including reviewing the appropriate utilization of resources, 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 clear, specific level of care orders and documentation in the medical record. May discuss alternative care options with the Emergency Department (ED) physician or attending physician. Works as a liaison, communicating with the patient, caregiver, multi-disciplinary team members, as well as post-acute and third-party payers. Collaborates with the care team to develop and implement discharge plans based on the patient’s individualized needs.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.
This job description summarizes the primary duties and responsibilities of the role. It is not exhaustive or all-inclusive. Contents are subject to change at the company's discretion.
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 the 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 Proficiency in using computers, software, and web-based applications.
Effective verbal and written communication skills, with the 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 schedule (e.g., 24/7, weekends, holidays, on-call).
Job Duties Performs pre-admission, admission, and continued stay reviews as directed per CMS guidelines, commercial payer guidelines, and hospital policy.
Supports service excellence, teamwork, and integrity, maintaining licensure standards and striving for professional development.
Maintains knowledge of conditions of participation related to utilization review and discharge planning.
Maintains open communication with all appropriate parties, functioning as a liaison between ED physicians, hospitalists, attending physicians, and physician advisors.
Leads oversight and management of functional and financial outcomes, including coordination and implementation of discharge plans during hospitalization.
Adapts behavior to the specific patient population, respecting privacy, explaining services appropriately, requesting permissions, and adjusting communication style.
Performs other related duties as required.
The above statements describe the general nature and level of work only. They are not exhaustive. Other duties may be added or amended at any time.
Remains knowledgeable on current laws, standards, and regulations applicable to the role and ensures compliance.
This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including immediate reporting of unethical or questionable behaviors, patient/employee safety, privacy, and other compliance concerns.
The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.
Physical and Environmental Demands The physical demands described are representative of those needed to perform the essential functions. Reasonable accommodations may be made for individuals with disabilities.
Medium Work - Exerting 20 to 50 pounds occasionally, 10 to 25 pounds frequently, and greater than negligible up to 10 pounds constantly. Tasks may involve walking, standing, sitting, pushing, and pulling. The role involves exposure to blood, body fluids, tissues, and potentially hazardous substances and environments.
Ready to make a difference? Apply Today! Ochsner Health does not consider an individual an applicant until they have formally applied on our careers website.
Individuals residing and working in Colorado, California, Hawaii, Illinois, Maryland, Minnesota, New York, Washington, and Washington D.C. are not eligible for remote positions.
For accessibility or accommodation requests, contact our HR Employee Solution Center at 504-842-4748 or careers@ochsner.org . This contact is for accommodation requests only.
Ochsner is an equal opportunity employer. All qualified applicants will receive consideration without regard to protected classes.