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RN Case Manager

Company: Choctaw Resort & Casino
Location: Talihina
Posted on: January 15, 2022

Job Description:

RN Case Manager

Description

Job Purpose or Objective(s):

Provides proactive case management for referred patients admitted to other facilities to ensure quality coordination of care as well as provides Disease Management for our complex patients to ensure the best outcomes

Primary Tasks:

-Request initial and concurrent reviews on inpatient stays for approved dates of service.
-Counsel patients, schedule appointments, data entry, communicates/coordinates with physicians and other departments regarding Choctaw Referred Care.
-Ensures services available within the CNHCC are utilized before the patients are referred out.
-Consult with Medical Staff to make correct decisions on referrals which do not fall within the CRC medical priority guidelines.
-Provide referral management based on the CRC medical priority guidelines.
-Fill in as needed for the Utilization Review Coordination by providing utilization management to outside insurance companies on the inpatient stays at CNHCC.
-Compile quarterly reports as requested to the Utilization Management Committee per policy.
-Ensure the appropriate documentation is utilized within the medical record to ensure continuity of care.
-Perform other duties as may be assigned.

Keywords: Choctaw Resort & Casino, Fort Smith , RN Case Manager, Healthcare , Talihina, Arkansas

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