Case Manager PRN

Overview:

Provides discharge planning and utilization review services in compliance with patients discharge planning needs and the hospital’s utilization review program.

SAFETY SENSITIVE POSITION:

This position is a designated as “Safety Sensitive Position” under Act 593 of the State of Arkansas. An employee who is under the influence of Marijuana constitutes a threat to patients/customers which Conway Regional is responsible for in providing and supporting the delivery health care related services.

Qualifications:

• Registered Nurse or Licensed Practical Nurse with current, active license to practice in Arkansas, required
• Proof of the highest level of nursing education achieved, required
• At least one-year experience in the area of case management/utilization review, preferred

Responsibilities:

• Apply clinical knowledge to determine appropriate acuity levels and utilization through chart review.
• Effectively organizes workflow to consistently complete assignments in a timely manner.
• Demonstrates ability to access and effectively utilize primary sources of data.
• Obtains and maintains medical records in conformance with Medical Information policies.
• Communicates with co-workers in a manner that is conducive to positive and effective working relationships. Demonstrates respect, honesty and integrity when working with other service providers.
• Demonstrates compliance with all relevant hospital, state and federal requirements related to maintenance of confidentiality of persons, data and information systems.
• Takes advantage of opportunities made available through CRHS and other professional organizations for continued professional growth and development.
• Responsible for analysis of patient information for determination of necessity of admission or continuation of stay.
• Review for medical necessity of admission on the first working day after admission using approved review criteria.
• Reviews inpatient procedures to determine appropriate utilization and acuity level. Reviews potential for outpatient setting or swing bed utilization.
• Reviews all patients for medical necessity of continued stay, or before the next review date, using approved review criteria.
• Performs retroactive reviews, as necessary, and responds to the appropriate review agency or third party payor.