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Inpatient RN Care Manager & UM - Eureka Hospital

Eureka, Illinois
Job Type
1 Aug 2022
The Care Manager for Carle Eureka Hospital Acute Care and Swing beds patients is accountable for the proactive coordination and timely transition of assigned patients to the most appropriate level of care along the continuum. The UM RN for Carle Eureka Hospital Acute care and swing bed patients is responsible for determining appropriate level care, being a liaison between the hospital and external payers to insure reimbursement.
  • Collaborates with Social Work to address identified needs and refers appropriate patients for complex discharge planning in a timely manner.
  • Montiors patient's progress and facilitates patient movement through the system in a timely manner, intervening as indicated to insure the plan of care and services provided are patient focused, efficient, cost effective, and directed toward maximizing clinical outcomes.
  • Identifies and facilitates resolution of system process problems impeding diagnostic or treatment progress.
  • Collaborates and communicates with the physician, patient, family, and members of the healthcare team to facilitate the coordination of care.
  • Arranges and participates in family conferences, as needed.
  • Coordinates the discharge planning process and arranges post-discharge services for patients, as needed.
  • Meets with identified patients/families to assess for discharge needs and develop individualized discharge plans.
  • Initiates and facilitates referrals for acute care transfers, acute rehab, home health care, IV infusion, and durable medical equipment.
  • Collaborates with payers for approval of discharge service authorization.
  • Identifies and resolves delays and obstacles to discharge.
  • Collects information from the patientGs medical record for the severity of illness, intensity of services, plan of care, and discharge plan and documents this clinical information in the clinical database.
  • Monitors inpatient, observation, and extended outpatient cases for medical necessity criteria and communicates with members of the healthcare team to ensure timely orders for appropriate changes in level of care.
  • Evaluates plan of care to insure care is based on accepted standards, evidence based practice, nationally accepted criteria, and current research.
  • Liaison function with external review agencies to insure compliance with regulations affecting financial reimbursement to the hospital.
  • Incorporates the role of educator into daily activities and facilitates the development of the multidisciplinary team members in the principles of care management.
  • May provide back up support of admission liaison for Swing bed referrals.
  • May provide back up support for Care Management function on Acute Rehab.
  • Care Coordination
  • Discharge planning
  • Utilization Review
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  • Job Reference: 673799069-2
  • Date Posted: 1 August 2022
  • Recruiter: Carle
  • Location: Eureka, Illinois
  • Salary: On Application
  • Sector: Healthcare & Medical
  • Job Type: Permanent