Case Manager-Discharge Planner

POSITION OVERVIEW (non-exempt):

Primary role is to assist with services provided to deal with social, psychological, and emotional needs of patients. To provide a coordinated planning program to meet each patient's post discharge needs. To assist with maintaining the day-to-day operations and coordination of the Utilization Reviews.

QUALIFICATIONS:

• Graduate of an accredited school of nursing, with current Iowa RN license
• Minimum of 2 years of hospital experience in provision of nursing care
• Knowledge of coding procedures, utilization review procedures and discharge planning helpful, but not required
• Experience with Indicia/MCG, prior authorizations, and case management preferred, but not required

ACCOUNTABILITY:

Reports to Quality & Infection Control Director

DIRECT REPORTS:

None

POSITION-SPECIFIC REQUIREMENTS:

• Daily continued stay review and documentation in Indicia/MCG
• Perform UR responsibilities in accordance with the facilities UR plan.
• Precertification of SNF stays/referrals.
• Ensure regulated CMS forms are signed and in the patient record.
• Within 2 business days of admission to IP, determine patient and/or family resources and anticipated discharge plan. When appropriate or with an order, DP will assess the observation patient, to assist with potential post hospitalization needs.
• Provide appropriate referrals and continuing care options in a timely manner.
  • PASRR screen on all patients transferring to a nursing home (to be completeld as soon as it is determined that there is a potential placement).
  • Complete Face to Face on all Home Health patients
  • Arrange for DME (includes obtaining order from physician, physician, nursing and therapy notes indicating need, and arrangements for delivery of the equipment)
  • Refer patients to Financial Services if indicated.
• Assist in maintaining a record of current community resources
• Leads patient care rounding for skilled patients
• Acts as liaison between providers, patient and family, and patient care team. Serves as a patient advocate.
• Assist with pre-certs, QI retrieval, and other duties as assigned.
• Attends all required health center meetings and in-services.
• Core Measure Monitoring as requested
• Department and Personal Goal reporting on a monthly or quarterly basis as assigned to align with the Strategic Plan and Core Measures/Dept. Goals
• Assist with discharge phone calls to the patients
• Assist with Emergency Dept. rounding

WORK ENVIRONMENT:

• Works in a well-illuminated, climate-controlled environment
• May come in contact with hazardous chemical or treatment modalities
• Possibility exists of exposure to communicable diseases
• Involvement in inpatient care may result in unavoidable work-related illness or injury
• Work environment is comfortable, with minimal exposure to physical hazards
• Moderate to loud noise environment when machines/equipment in use
• Involvement in checking in/moving of supplies may result in unavoidable work-related injury
• Must be constantly alert for patient/family emergency situations