Case Manager Nurse Nurse Allied jobs in Louisiana

Summary: The Utilization Management Nurse I is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse is responsible for performing a variety of pre-admission, concurrent, and retrospective UM related reviews and functions.

The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of utilization review, discharge planning and resource utilization. Job responsibilities include but are not limited to daily review of medical records to determine appropriateness and medical necessity of admission, continued hospital stay and use of resources and discharge readiness. Requires physical stamina and emotional stability. RN License required.

The Case Manager will facilitate the interdisciplinary plan of care with a focus on evaluating the appropriateness of clinical care, medical necessity, admission status, level of care, and resource management. The Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization.

The Case Manager 1 directs the utilization review of patient charts, treatment plans, and discharge planning pertaining to the quality of care and treatment criteria for patients in a specific department. The Case Manager 1 specializes in the review of information pertaining specifically to the assigned areas. Relies on education, experience, professional training and judgment to accomplish responsibilities. A wide degree of creativity and latitude is expected.

The Case Manager will facilitate the interdisciplinary plan of care with a focus on evaluating the appropriateness of clinical care, medical necessity, admission status, level of care, and resource management. The Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization.

This position is responsible for the day-to-day operations of the case managers, social workers, utilization review staff, and case management assistants, under the general direction of the Case Management Director. The position will integrate knowledge, skills, and experiences to meet the needs of patients and families throughout the continuum of care. They rely on extensive experience and judgment to accomplish responsibilities.

The Registered Nurse provides safe therapeutic care in a holistic and systematic way, incorporating differences into the provision of care. Integrates knowledge, skills, and experiences to meet the needs of patients and families throughout the continuum to include patient and family education. Relies on education and training to complete responsibilities within scope of licensure as registered nurse.