Case Manager-Discharge Planner

POSITION OVERVIEW

(non-exempt): Primary role is to assist with services provided to deal with social, psychological, and emotional needs of patients. To provide a coordinated planning program to meet each patient's post discharge needs. To assist with maintaining the day-to-day operations and coordination of the Utilization Reviews.

QUALIFICATIONS

Graduate of an accredited school of nursing, with current Iowa RN license Minimum of 2 years of hospital experience in provision of nursing care Knowledge of coding procedures, utilization review procedures and discharge planning helpful, but not required Experience with Indicia/MCG, prior authorizations, and case management preferred, but not required

ACCOUNTABILITY

Reports to Quality & Infection Control Director

DIRECT REPORTS

None

POSITION-SPECIFIC REQUIREMENTS

Daily continued stay review and documentation in Indicia/MCG Perform UR responsibilities in accordance with the facilities UR plan. Precertification of SNF stays/referrals. Ensure regulated CMS forms are signed and in the patient record. Within 2 business days of admission to IP, determine patient and/or family resources and anticipated discharge plan. When appropriate or with an order, DP will assess the observation patient, to assist with potential post hospitalization needs. Provide appropriate referrals and continuing care options in a timely manner. PASRR screen on all patients transferring to a nursing home (to be completeld as soon as it is determined that there is a potential placement). Complete Face to Face on all Home Health patients Arrange for DME (includes obtaining order from physician, physician, nursing and therapy notes indicating need, and arrangements for delivery of the equipment) Refer patients to Financial Services if indicated. Assist in maintaining a record of current community resources Leads patient care rounding for skilled patients Acts as liaison between providers, patient and family, and patient care team. Serves as a patient advocate. Assist with pre-certs, QI retrieval, and other duties as assigned. Attends all required health center meetings and in-services. Core Measure Monitoring as requested Department and Personal Goal reporting on a monthly or quarterly basis as assigned to align with the Strategic Plan and Core Measures/Dept. Goals Assist with discharge phone calls to the patients Assist with Emergency Dept. rounding

WORK ENVIRONMENT

: Works in a well-illuminated, climate-controlled environment May come in contact with hazardous chemical or treatment modalities Possibility exists of exposure to communicable diseases Involvement in inpatient care may result in unavoidable work-related illness or injury Work environment is comfortable, with minimal exposure to physical hazards Moderate to loud noise environment when machines/equipment in use Involvement in checking in/moving of supplies may result in unavoidable work-related injury Must be constantly alert for patient/family emergency situations

Location:

Jefferson County Health Center •

Quality Assurance Schedule:

Full Time, Days, Four 10-hour days or five 8-hour days