RN Case Manager

US-SD-Rapid City | US-SD-Rapid City
Req No
2017-3676
Category
Production Coding
Type
Contract to Permanent (Full Time)

Overview

 

 

Peak Health Solutions is a growing company with a robust list of company services.  Peak offers HIM professionals with flexible career options and helps healthcare providers improve clinical documents to ensure accurate outcomes and timely reimbursement.  Peak celebrates 10 years in the HIM space, with an executive team of high-profile, industry leaders.

 

Provide initial and ongoing assessments of the patients’ needs for services in collaboration with the healthcare team. Monitor and evaluate utilization of those services to focus on the best treatment and approach for the patient promoting the timely progression of interventions, utilization of resources and expected outcomes within a length of stay consistent with external regulations and standards.

 

Provide transition planning coordination to include identifying needs and implementing referrals to other clinical care providers. Evaluate patient progress and revise the care plan if needed. Act as a resource for physician office, physician and staff regarding Intensity Severity Discharge (ISD) criteria. Identify barriers to achieving patients discharge and assist the care team in overcoming them.

 

Provide patient/family education to facilitate an understanding of their hospital and post-hospital course, their status assignment and discharge appeal rights and provide advocacy for their care.

 

Effectively communicate and provide clear and concise documentation according to department standards and regulatory requirements. Refer to appropriate internal and community resources as necessary.

 

Act as care management resource by demonstrating critical thinking, portraying a professional image of competency to customer and staff and demonstrating effective verbal and written communication with everyone. Maintain knowledge of CMS, Medicaid, and regulatory agency standards, Department of Health (DOH), Emergency Medical Treatment and Active Labor Act (EMTALA). Serve as a clinical resource and/or liaison.

 

Perform other related duties as may be assigned.

 

Peak Health Solutions, an AMN Healthcare company, is an EEO/AA/Disability/Protected Veteran EmployerWe encourage minority and female applicants to apply

Responsibilities

 

 

Qualifications

Current RN License 

 

OTHER SKILLS:  

  • Strong verbal, written and interpersonal communication skills.
  • Extensive knowledge of diseases, clinical procedures, treatment, prognosis and hospital functions.
  • Ability to effectively communicate clinical information.
  • Strong analysis/problem solving skills.
  • Skill in the evaluation of quality and appropriateness of care.
  • Proven leadership ability. Strong organization skills with the ability to work in a fast-paced environment independently or as part of an interdisciplinary team.
  • Computer skills to include proficiency in keyboarding and data entry.
  • Critical thinking skills, able to assess, evaluate and teach.
  • Knowledge of discharge planning, health care reimbursement, utilization review processes and Medicare admission status/classification level.
  • MS Office proficiency preferred.

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