Coordinates with physicians, staff and non-Kaiser providers and facilities regarding patients' transitions and discharge planning. In conjunction with physicians, develops plans of care and discharge plans, and makes recommendations for alternative levels of care as required.
*Utilization Management: Performs daily pre-admission, admission, and concurrent utilization reviews using guidelines, institutional policies/procedures, and other information to determine appropriate levels of care and readiness for discharge.
*Monitors the progression of the discharge plan and facilitates discussions with the multidisciplinary teams
*Educates other healthcare team members on utilization and care coordination.
*Collaborates with and provides information to patients, families, physicians, and staff regarding the discharge plans and transitions
*Understands and consistently applies the interpretation, and utilization of member health care benefits.
*Conducts UM, care coordination and discharge planning activities according to all applicable regulatory requirements.
*Discharge Planning: Ensures continuity of care through communication in rounds and written documentation, level of care recommendations, transfer coordination, discharge planning and obtaining authorizations/approvals as needed for outside services for the patient
*Develops, evaluates, and coordinates a comprehensive discharge plan in conjunction with the patient/family, physician, nursing, social services, and other health care providers and agencies.
*Regulatory: Conducts UM, care coordination, and discharge planning activities according to all applicable regulatory requirements
Case Manager Remote
Seasoned Utilization Review Nurse with preference ER
Ability to apply Case Management Process
Needs RN license for MD/VA and/or DC
Accountable, Flexible , Professional, Collaborative, Resource Management, Technologically savvy as this is a Remote Position.Will spend about 20% of the time at New Carrolton/Hyattsville
We have a big need for evenings and weekends.
Preference experience w/ MCG (Interqual is okay)
At American Mobile Healthcare we take care of our travelers! We offer:
Competitive pay rates
Free, quality, private housing
Medical, Dental, Vision
401(k) and Flex Spending
Accident and Short-term Disability Coverage
Free Continuing Education
Refer a friend and earn extra cash!
About The Company
Since its inception in 1985, American Mobile Healthcare has set the highest standards in professional recruitment for the travel healthcare industry. Our professional staffing team offers unparalleled customer service and industry commitment, as well as top pay and benefits. American Mobile Healthcare is an EEO/AA/Disability/Protected Veteran Employer. We encourage minority and female applicants to apply