"RN - Case Manager - Inpatient Care Management - Multiple Shifts"

To coordinate, negotiate and obtain services and resources for the care of patients. To review case criteria to determine medical necessity for admission and continued stay. To provide discharge planning and care coordination that identifies the most cost effective methods of patient care.

1. Applies general medical necessity criteria to patient medical records and abstracts relevant patient care data to determine the appropriate level of patient care. Refers all potential quality care issues to the manager daily to facilitate timely follow-up.
2. Documents all discharge planning referrals and all discussions with the patient, family and care team members. Coordinates patient placement in post acute care provider facilities. Performs cost/benefit analysis to determine the most cost effective post acute care plan for patients.
3. Educates physicians and other care team members on level of care criteria and other third party payer requirements.
4. Explores and implements strategies to reduce the length of stay within assigned caseload. Identifies the need for new resources if gaps exist in service continuum and initiates creative care delivery options.
5. Monitors the effectiveness of the patient's care plan in reaching identified goals. Intervenes when necessary to address potential progression delays.
6. Performs other duties as assigned.