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RN - Case Manager

Cynet Health • Portales, New Mexico • $59.15 / hour • 2w ago

RN - Case Manager

Profession: Mid-Revenue Cycle Solutions

Specialty: Acute Care RN Case Manager

Duration: 13 weeks

Shift: 0800-1630

Hours per Shift: 40

Experience: Minimum 5 years

Description: This position is responsible for routine case management and discharge planning. Conduct swing bed coordinator and utilization review duties. Evaluate and screen potential admissions to the swing bed program. Knowledgeable of criteria for Medicare, Medicaid, HMO, swing bed, and private insurance coverage. Initiate ongoing communication with residents and their families to assess discharge needs. Actively involved in daily rounds with bedside staff, physicians, and ancillary team members. Communicate with physicians to ascertain their plans for timely discharge. Document updates and discharge planning as part of ongoing review. Manage and collaborate with the healthcare team on swing bed placements. Complete MDS documentation as necessary. Assist with obtaining referrals and prior authorization for home health care, CME, SNF, acute rehab, and appointments. Educate physicians and staff regarding appropriate levels of care/utilization and required documentation that meets admission status. Run Interqual for each inpatient and observation patient admitted.

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