Date:Oct 9, 2013
Location:Durango, CO, US
Physical Location:MRM-Mercy Regional Medical Center
Department Name:MRMC UTILIZATION ASSESSMENT
Status:Per Requested Need (PRN)
Hours per Pay Period:PRN
Required Education:Associates Degree
Required Experience:Experience Preferred
Certificate/Licensure:Colorado RN License
Contact Information:Pati Sandhaus
JOB SUMMARY: The Case Manager will monitor the medical record to assure proper utilization of hospital resources and length of stay. This person will review the medical record for Intensity of Service and Severity of Illness (IS/SI) criteria and provide clinical reviews to insurance companies as requested. Initiation of discharge planning will begin as early as determination of the need for such service is indicated. Discharge planning will be done in collaboration with the patient, significant others, the physician and the Interdisciplinary Team. Discharge planning will include placement in long term care facilities and referrals to services that may be required to improve or maintain the patient's health status and safety. Service is provided to infants, pediatrics, adolescents, adults, and geriatric patients. .Demonstrates principles of growth and development for the entire life span with the ability to provide care appropriate for the infant, pediatric, adolescent, adult, and geriatric patients.
Job Requirements (Core Competencies)
Education: Minimum education: R.N. licensure, B.S.N. preferred
Experience: One year utilization management/discharge planning experience preferred. Three years clinical nursing experience.
License/Certification: Current Colorado LPN or Registered Nurse Licensure
Other required skills and abilities: Working knowledge of the community's resources preferred. Knowledge of hospital routine as it relates to admissions and patient placement. Knowledge of current utilization management
principles, PRO criteria and standards, third party payer requirements and discharge planning process. Excellent verbal and written communication skills. Ability to establish a smooth working relationship with Medical Staff, Nursing Service, Social Services, Home Health/Hospice and other departments.
Self direction and ability to function independently.
Physical Abilities: Vision sufficient to read medical records, instruments, documentation, and visual changes in
client condition. Hearing sufficient to interact with client who may be unable to speak at normal voice level. Mobility (including lifting, bending, stooping, reaching) and dexterity sufficient to assist clients and handle required instruments. See Physical Demands Assessment
This is not a new grad position