PRN/Casual Case Manager (RN or Social Worker)
Core
Plans care for targeted patient populations, manages resources, and facilitates discharge planning and transitions to post-acute care.
Role type
Case Manager (RN or Social Worker)
Builds
Discharge plans and care transitions for assigned patients
Domain
Healthcare / Case Management
Deliverable
client delivery
Required skills
Denial management, Utilization management, Discharge planning, Care facilitation, Referral coordination, Resource management, Documentation, Clinical reviews, Medical necessity determination, Level of care screening, Financial management coordination, Payer regulation knowledge
Preferred skills
Bachelor's degree in Nursing (BSN)
Technologies
Electronic record systems
Responsibilities
Manage transition/discharge planning for assigned patients, Monitor patient progress and intervene as necessary, Provide education to staff, physicians, and patients/families, Meet with patients/families to assess needs and develop individualized plans, Initiate and facilitate referrals to post-acute services, Communicate transition plans to the multidisciplinary team, Document interactions and planning activities, Assist patients/families with advance directives, Collaborate on resource and financial management, Utilize quality screens to identify potential issues, Complete clinical reviews, Apply utilization criteria to ensure medical necessity, Screen for authorization and level of care, Facilitate covered day reimbursement certification, Educate staff on payer regulations, Foster integration of staff and students