Case Manager | RN or Social Worker | Full Time (2nd shift) | Hospital

Registered Nurse or Social Worker | Case Manager | Full Time (2nd shift) 

Performs and manages utilization review and discharge planning.

REQUIREMENTS

  • Current Michigan RN license or Certified Social Worker, Case Management certification preferred
  • RN must have associates degree, Bachelor’s degree preferred, five years’ experience as a staff nurse in Med/Surg and ICU required; in ER as well is a plus
  • Social worker must have graduation from an accredited master’s degree program, school of social work and/or school or counseling. One year of full-time experience as a clinical social worker preferred
  • BLS, CPI certification (available through Hillsdale Hospital
  • Prior experience in case management, utilization review, discharge planning preferred; medical record documentation specialist preferred
  • Must be committed to Service Excellence and embrace the Vision, Mission, values and culture of Hillsdale Hospital
  • Must be flexible, dependable, responsible and a team player with a favorable attendance record

RESPONSIBILITIES

  • Maintain good relations with patients, medical staff, other departments, third party payors (clinical review), and outside agencies and resources (discharge planning).
  • Maintain departmental records (Interqual prenote, UR worksheets, CPS/APS forms, audit forms) and quality assurance reports
  • Notification to all fee sources of patient hospitalization appropriate (precertification)
  • Perform initial and concurrent reviews for third party payers, obtaining authorization for hospitalization
  • Review medical records concurrently and discuss necessary documentation requirements with physicians
  • Responsible for coordination of discharge planning in conjunction with other disciplines
  • Assure and perform complete and comprehensive documentation in medical records
  • Maintain compliance with HFAP requirements and quality assurance initiatives