Care Manager Rotation Schedule WJMC

Your job is more than a job

Why a Great Place to Work:

You're more than your job. Everyone is. And that's what makes you great at your job-all the little extras you bring to work every day, the things that make you you. At LCMC Health we value those things about you, because we know that all those little extras add up to extraordinary. And we've built a culture that supports and celebrates the extraordinary. You'll see it when you come to work here, in the spirit of our places and the faces of our people. And every patient we heal, every family we comfort, every life we improve is the outcome of countless little extras adding up to an extraordinary result. Join LCMC Health, and you'll find that our everyday makes it easy to live your extraordinary.

Essential Function:

GENERAL DUTIES

• Coordinates written/verbal communication relating to the medical treatment plan (patient/family/physician/other care team members) and communicates the treatment plan to external agencies, as needed:
• Assists with organizing services across provider lines, between people, and systems to affect optimal patient outcomes, achieve continuity of care and reduce costs.
• Uses daily worklist to review payer source, patient information, physician information, etc. from hospital systems.
• Prioritizes cases according to financial reimbursement and clinical criteria.
• Works cohesively with the interdisciplinary team and appropriate nursing staff in the coordination of the transitions in levels of care or discharge planning. Establishes a rapport with physicians and interacts face to face or telephonically with physicians/NPs to discuss plan of care, documentation, clarification, and obtain orders to consult and or transfer patients through the continuum as appropriate.
• Provides ongoing follow up with patient/care giver. Telephonically evaluates patient conditions and provides follow up based on needs identified.
• Financial Management:
• Obtains pre-certification of post-acute care when required. Informs the attending/primary care physician, nursing staff, patient/caregiver of post- acute care services denied by insurance providers and rights to appeal when applicable.
• Maintains a current list of resources for referrals and refers to the appropriate inpatient, outpatient and community resources.
• Maintains working knowledge of Medicare, Medicaid, private insurance company coverage for referred products and services.
• Collaborates with physicians, caregivers, patient/family, other departmental team members, payor to proactively develop and implement a safe, timely and appropriate discharge plan.
• Resource Consumption:
• Identifies resource consumption patterns and suggest alternatives to meet patients' needs to the attending or other members of the healthcare team.
• Provides feedback to physicians regarding practice pattern issues and documentation to substantiate (IS/SI) severity of illness.
• Able to screen patients at intake such that appropriate post-acute level of care is determined initially.
• Obtains appropriate documentation and data to support patients discharge plan.
• Discharge Planning:
• Utilizes the nursing process to coordinate the care of patients discharged by LCMC and referred emergency department patients.
• Interacts with the nursing staff/care coordinator staff when needed the physician, patient/family and other healthcare team members to formulate a discharge plan pertinent to the patient's physical, psycho-social and financial parameters. Reviews and discusses with patient/care giver(s) discharge instructions including red flag indicators, medications, follow up appointments and follow up care.
• Facilitates the patient's discharge plan while utilizing opportunities to maximize cost-effective, quality care.
• Interacts daily with all health team disciplines involved in the patient's care in order to identify issues or obstacles in progress toward treatment plan goals and facilitates problem solving and revision of discharge plan if necessary.
• Manages cases on a daily basis to avoid denials and documents reasons for discharge delays and avoidable days in hospital information system.
• Sets up doc-to-docs and provide pertinent information to appeal any denials, refers cases for appeal and assist with history of case.
• Maintains a working knowledge of electronic discharge program and utilizes it for documentation of discharge arrangements.
• Identifies and coordinates resources needed to ensure continuity of care which may include arranging transportation, medication assistance, home health, durable medical equipment, hospice, palliative care or social services support.

EXPERIENCE QUALIFICATIONS

• 2 years Nursing experience in clinical area

LICENSES AND CERTIFICATIONS

• Certification Name: Current LPN Louisiana License.

The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.

WORK SHIFT:

Variable Hours (United States of America)

LCMC Health is a community.

Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little "come on in" attitude is the foundation of LCMC Health's culture of everyday extraordinary

Your extras

• Deliver healthcare with heart.
• Give people a reason to smile.
• Put a little love in your work.
• Be honest and real, but with compassion.
• Bring some lagniappe into everything you do.
• Forget one-size-fits-all, think one-of-a-kind care.
• See opportunities, not problems - it's all about perspective.
• Cheerlead ideas, differences, and each other.
• Love what makes you, you - because we do

You are welcome here.

LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.

The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.

Simple things make the difference.

1. To get started, take your time to fully and accurately complete the application for employment. Incomplete applications get bogged down and are often eliminated due to missing information.

2. To ensure quality care and service, we may use information on your application to verify your previous employment and background.

3. To keep our career applications up-to-date, applications are inactive after 6 months and, therefore, require a new application for employment to be completed.

4. To expedite the hiring process, proof of citizenship or immigration status will be required to verify your lawful right to work in the United States.