HCA, Hospital Corporation of America RN Case Manager in Gulfport, Mississippi
GENERAL SUMMARY OF DUTIES - The RN Case Manager works with physicians and other members of the multidisciplinary team to develop a plan for each patient from admission to discharge. The tasks and responsibilities include:
DUTIES INCLUDE BUT ARE NOT LIMITED TO: 1. Performs continuous assessments and evaluations to ensure patient is progressing towards desired outcomes. 2. Assesses and responds to patient/family needs by coordinating efforts of other team members. 3. Identifies and resolves barriers that hinder effective patient care. 4. Collaborates and consults with physicians on patient's progress and discharge planning needs. 5. Performs utilization review ensuring admissions meet criteria for appropriateness of care and medical necessity. 6. Manages the process to review and, as appropriate, appeal denials received from payors. 7. Coordinates the discharge planning process ensuring involvement of all members of the healthcare team. Counsels with patients and family members in decision making and in meeting psycho social needs of the patient. 8. Maintains knowledge of resources and facilities available to patients and family members. 9. Collaborates with personnel at other facilities to coordinate smooth and effective patient transfers and transitions. 10. Compiles, evaluates, and reports statistics to members of the team and utilizes the information to facilitate process improvement activities. 11. Orients and mentors new staff members. 12. Follows Standard Precautions using personal protective equipment as required. 13. Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement".
KNOWLEDGE, SKILLS, & ABILITIES - This position requires the following minimal requirements: 1. Must have customer service abilities including effective listening skills. 2. Must be detail-oriented with ability to sustain concentration over long periods of time. 3. Must have critical thinking skills, decisive judgment and the ability to work with minimal supervision in a fast paced environment. 4. Must role model ethical, safe, fiscally responsible practices 5. Must be able to read and comprehend written instructions and follow verbal instructions. 6. Must have the ability to handle multiple priorities. 7. Must demonstrate teamwork and team building skills
EDUCATION - RN with current state licensure, BSN preferred
EXPERIENCE - Minimum 5 years of clinical nursing experience. Knowledge of CMS guidelines and experience working with payor specific guidelines and contractual rules preferred.
CERTIFICATE/LICENSE - Certification in Case Management, Nursing, or Utilization Review, preferred
/Making Garden Park Medical Center a great place to work is a top priority/
At Garden Park, we want to be the employer of choice on the Mississippi Gulf Coast. We understand that our employees juggle multiple demands both in and outside of the workplace.
For this reason, we offer a variety of programs and resources to help meet your needs. Our focus is clear: a culture focused on recruiting and retaining talented employees within a culture where you are our top priority. An EEO/AA Employer M/F/V/D.
Title: RN Case Manager
Location: Mississippi-Gulfport-Garden Park Medical Center
Requisition ID: 06212-2783