Greenkey Resources LLC

Compensation

Full Description

Overview • Provide critical care coordination and case management services in an acute hospital setting. • Collaborate with interdisciplinary teams to ensure seamless patient transitions and optimal resource utilization. • Facilitate discharge planning and post-acute care arrangements for patients. • Work closely with insurance providers to secure necessary authorizations and manage care plans. • Ensure compliance with hospital policies, regulatory standards, and evidence-based guidelines. • Contribute to reducing readmissions and enhancing patient outcomes through effective care coordination. • Operate within a fast-paced environment, leveraging critical thinking and problem-solving skills. • Document case management activities accurately in the Electronic Medical Record (EMR). Key Responsibilities & Duties • Conduct comprehensive patient assessments to determine care plans and discharge needs. • Collaborate with patients, families, and interdisciplinary teams to implement discharge plans. • Assist in removing barriers to timely discharge and securing payer authorizations. • Partner with Utilization Review teams to ensure appropriate level of care and documentation. • Educate patients and families on healthcare navigation strategies and available resources. • Facilitate interdisciplinary rounds, family meetings, and care conferences as needed. • Maintain knowledge of managed care, payer environments, and CMS regulations. • Collaborate with social workers and community partners to address social determinants of health. Job Requirements • Active RN license in the applicable state(s). • BLS certification required for hospital-based roles. • Minimum 2 years of acute hospital nursing experience. • Experience in Care Coordination, Case Management, or Utilization Management preferred. • BSN degree or equivalent experience preferred. • Certified Case Manager (CCM) or Accredited Case Manager (ACM-RN) certification preferred. • Proficiency in prioritization, delegation, and time management. • Knowledge of managed care, payer environments, and CMS regulations.