Case Manager - (US-KY-London - 40745)

Minimum Education: None
Job Type: Full Time
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Responsibilities : Provides clinical information to third party payors. Demonstrates discretion when dealing with sensitive issues involving patients, families, and physicians to maintain confidentiality of patient and hospital records. Documents accurately and completes information related to third party authorization of hospital services.Documents discharge plan on medical record as needed.Facilitates appropriate clinical documentation to ensure the level of services and acuity of care accurately reflected in the medical record. Updates DRG worksheet to reflect any changes in patient status, procedures/treatments, and confers with the physician to finalize diagnosis.Conducts follow-up reviews of clinical documentation to ensure issues discussed and clarified with the physician have been recorded in the patient's chart.Assists in the medical screening process by documenting appropriateness of patient admission, working DRG & LOS information on the worksheet and computer system as appropriate.Reviews record of all patients on observation status and intervenes as needed.Reviews records of all patients on assigned units and intervenes when indicated.Utilizes hospital policy in handling request for medical record information for patients.

Requirements :Graduate of accredited Nursing program preferred.Experience:One (1) year experience in case management or utilization review or clinical pathway development.Five (5) years experience in a clinical setting.Two (2) years charge nurse/team leader or related experience. office machine and computer experience including Fax machine, Computer, Pager, Telephone/Voice Mail.License/Certifications:Valid State RN or LPN license required.BLS Certificate required. Additional Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times.Adheres to and exhibits our core values:Reverence: Having a profound spirit of awe and respect for all creation, shaping relationships to self, to one another and to God and acknowledging that we hold in trust all that has been given to us.Integrity: Moral wholeness, soundness, uprightness, honesty and sincerity as a basis of trustworthiness.

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