Case Manager Emergency Services - HCA (Las Vegas, Nevada) in Las Vegas, Nevada For Sale
Position Summary: The RN Case Manager/Utilization Review Nurse is responsible for assessing discharge planning needs for the patients and coordinate the delivery of healthcare services in conjunction with nursing, physicians, ancillary hospital departments, patients and families. Will identify and coordinate post-hospital needs of all patients, infant through geriatrics, in order to promote quality, continuity of care and safety for the patient. She/he will facilitate to meet those needs, to facilitate timely and appropriate discharges from the hospital, and to identify opportunities for improvements in patient care. Will facilitate Care Coordination through the IDT (Interdisciplinary Team) rounds and will act as a patient advocate, investigate all adverse occurrences, perform staff education related to utilization or resources, discharge planning, and psycho-social aspects of healthcare delivery. In addition, must provide documentation of all functions as required by regulatory agencies; will monitor utilization of resources; track any avoidable days identified; provide clinical reviews in a timely manner utilizing InterQual criteria; follow review protocols for the department; determine the medical necessity for all admissions and need for continued stay, as well as be able to status the patient in the correct level of care Observation VS. Admissions.
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