Utilization Review & Swing Bed RN Case Manager
Portales, NM
Learnbeyond Healthcare
5x8 hrs
Referral Bonus

Job Description:

This position is responsible for:Routine case management, discharge planning, swing bed coordinator and utilization review duties.Evaluating and screening potential admissions to the facilities swing bed programknowledgeable of criteria for Medicare, Medicaid, HMO, swing bed and private insurance coverageInitiate ongoing communication with the resident and resident's family to assess discharge needs.Actively involvement in daily rounds with bedside staff, physicians and ancillary team membersCommunicate with physicians to ascertain their plans for a timely discharge.document updates and discharge planning as an ongoing review.Manage and collaborate with the healthcare team on swing bed placement and complete MDS documentation as necessary.assist with obtaining referrals, prior authorization for Home Health Care, CME, SNF, acute rehab and appointments.Educates physicians and staff regarding appropriate level of care/utilization and required documentation that meets admission statusRun Interqual for each IP and OBS patient admitted to the floor

Position Urgency:
Normal

Shifts:
0800-1630

State License Details:
Must Be Currently Active

Minimum Years of Experience:
5

Sub Specialty:
Acute Care RN Case Manager Discharge Planning, Acute Care RN Case Manager Util Rev/Appeals & Denials, Acute Care RN Case Manager Util Rev/Discharge Planning , Acute Care RN Case Manager Utilization Review

General Certifications:, N/A

Nursing Certifications:

Contract Length in Weeks:
13