Kadlec has an exciting opportunity for a Case Management Specialist\-RN to join our growing team\!
Shift Details: Full time, 1\.0\. Day shifts\.
- Graduation from an accredited school of nursing required\.
- Current WA State RN Licensure required\.
- Current American Heart Association Healthcare Provider BLS required\.
- Bachelor's Degree from an accredited educational institution preferred\.
- Two years recent inpatient clinical experience in an acute care facility preferred\.
- Previous Case Management, discharge planning or utilization review experience preferred\.
- Prefer bi\-lingual or multi\-lingual skills\.
Duties include, but are not limited to, the following:
As aCase Management Specialist \- RNyou willprovide clinically\-based case management to support the delivery of efficient patient care\. Has the overall accountability for the integrated responsibilities of case management; utilization management, discharge planning, facilitation and coordination of care\. Collaborates with other members of the health care team to identify appropriate utilization of resources and to ensure reimbursement\. Utilizes criteria to confirm medical necessity for admission and continued stay\. In conjunction with the patient, family and healthcare team, creates a discharge plan appropriate to the patients' needs and resources\.
- Completes an initial screen of all patients within 24 hours of admission utilizing InterQual criteria to identify needs related to utilization management and/or discharge planning\. Refers appropriate cases to Social Work based on established referral criteria and professional judgment\.
- Introduces self to the patient/family, explains the Specialist, Case Management –RN role, and provides patient/family with a business card\.
- Integrates the discharge planning/coordination and utilization review functions in the case management role\.
- Collaborates with all members of the multidisciplinary team to facilitate the case management and care coordination processes for the assigned caseload\.
- Evaluates patients for appropriateness of admission type and setting, utilizing a combination of clinical information, screening criteria, and third party information\.
- Validates admission criteria with third party payers \(including onsite and telephonic Case Management Specialists\) as well as Primary Care and Attending Physicians\. Recommends alternative care sites where appropriate\.
- Administers HINN's \(Hospital Issued Notices of Non\-Coverage\) as appropriate\.
We offer a full comprehensive range of benefits — see our website for details —
Provide safe compassionate care\. We promise to answer the call of every person we serve; to know them, care for them and ease their way\. We are committed to safety, compassion, respect, integrity, stewardship, excellence and collaboration\.
Located in sunny Tri\-Cities, WA, Kadlec is the largest non\-profit healthcare provider in the region\. Kadlec is the premier choice for customer service excellence, providing compassionate healthcare to the region by combining cutting\-edge technology and innovation with evidence\-based, patient\-focused care\. Kadlec is proud to be part of Planetree \(Planetree\.org\) and continues to be recognized nationally as a "Best in Class Employer"\. Kadlec does not unlawfully discriminate on the basis of race, sex, sexual orientation, age, color, religion, national origin, genetic information, marital status, veteran status, disability status, or any other characteristic protected by Federal, State, or Local Law\. EOE\.To learn more, click here: http://www\.kadlec\.org/careers/about\-kadlec
Job Category: Social Work / Care Management / Counseling
Req ID: 144537