Care Manager – Emergency Dept

Care Manager – Emergency Dept

Requirements

• Registered Nurse License issued by the state in which the Team Member practices
• Bachelor’s degree in Nursing
• 2 years in clinical nursing
• Ability to prioritize and organize work
• Effective communication skills
• Utilization of critical thinking and timely decision making
• Ability to navigate the Electronic Health Record
• Basic utilization of MS Office products
• Knowledge of Medicare A and B guidelines
• Knowledge of Managed Care program requirements/implications
• Ability to apply elements of Utilization Management programs

Responsibilities

• Identifies targeted patients within scope for ED CM interventions
• Conducts focused assessments, establishes appropriate plans, and initiates interventions within desired timeframes
• Collaborates and negotiates effectively with patient, family, and ED team
• Provides continuity of care and discharge planning services compliant with regulatory standards
• Provides case management services related to various levels of health care, finances, housing, family discord, or illness adjustment
• Initiates internal and external referrals to secure services as an alternative to hospital admission
• Documents discharge planning interventions and patient status screening activity per department and medical center standards
• Collaborates with managers, physicians, medical directors, advisory groups and treatment teams for issues related to physician practices and best practices
• Remains knowledgeable in issues of healthcare regulations, reimbursement issues, impact on hospital admission, discharge planning, and community resources
• Develops and maintains productive relationships with community-based agencies and networks
• Serves as an educator and expert resource to ED and hospital staff regarding admission status and acute care criteria

Preferred Qualifications

No preferred qualifications provided.