Job Location : Tupelo,MS, USA
North Mississippi Health Services is seeking a per diem / prn nurse RN Case Management for a per diem / prn nursing job in Tupelo, Mississippi.
Job Description & Requirements**Review Activities:*** monitors individual cases in relation to established criteria, LOS & patient care guidelines* assures patient is meeting level of care criteria & issues denial of care letters as necessary* intervenes as indicated to promote the timely provision of care & utilization of resources* serves as a resource for physicians & nurses in understanding criteria for continued stay & medical necessity* monitors patient outcomes to evaluate clinical & financial effectiveness* reconciles services rendered with patient benefits & communicates with physicians & 3rd party payers to assure appropriate reimbursement**Clinical Practice:*** collaborates with patient care team to move population along the continuum by effectively planning for continued care as moving to another level of care to ensure all patient needs are addressed* assesses social/emotional factors affecting health status of patients & makes appropriate referrals* participates on Discharge Planning Team & initiates d/c planning early in the treatment process based on requirements of the plan of care & needs identified during initial assessment**Swing Bed Responsibilities:*** participate on SWB Team and facilitates screening of patients for eligibility* provides SWB information to patients & families as appropriate* monitors patient progress for timely discharge to the appropriate setting* assists with MDS as required for billing/reimbursement as needed**Reports:*** identifies & reports physicians practice patterns & resource utilization* maintains accurate records of review & discharge planning activities* trends & reports lack of medical necessity for admissions, observation vs admission appropriateness, and LOS**Customer Service:*** maintains constructive working relationships & communication with physicians, professional staff, and other members of the health care team regarding issues of continued stay & documentation of medical necessity* collaborates with business office to ensure accurate billing and statistical information* collaborates with social worker to identify & coordinate resources, internal and external, to best meet patient needs* competent to communicate on all levels to assess discharge needs of all age groups of patientsparticipates in educational meetings with physicians office personnel as requested Job Knowledge: * currently licensed in Alabama as a Registered Nurse & in good standing with the State Board of Nursing* minimum of 5 years of experience with a broad base of clinical expertise* ability to read & interpret medical record documentation* ability to operate a PC* good organizational skills & high level of self-initiative* effective verbal & written communication skillsmaintains current ACLS and BLS certifications
North Mississippi Health Services Job ID #2232-0008PM. Posted job title: Case Manager - Tupelo, Prn
About North Mississippi Health ServicesAt North Mississippi Health Services, we believe in connecting you to a career that challenges you, engages your mind and inspires you to be the “you” you always wanted to be. We also believe in celebrating everything that makes you uniquely you – your talents, your perspectives and your passions – and connecting you with others to create a supportive and innovative team that aspires and achieves together. Most of all, we believe in helping you leverage and connect your personal passion with a much greater purpose. We're committed to helping our team of over 7,000 unique individuals discover what connects you to our mission, vision and ultimate “why” – our patients.
With seven hospitals, more than 60 clinics, four long-term care facilities, state-of-the-art women's and behavioral health facilities and multiple outpatient care centers, we have a variety of career opportunities waiting for you.