ACI Federal is seeking an RN Case Manager for Transitional Care to join our team today! The RN Case Manager functions as a resource and advocate on behalf of the patient and family while assisting in the navigation of the health care delivery continuum by operationalizing multiple processes. This position will coordinate hospital transitions to the next level of care; including, but not limited to, medical community partners, and ambulatory clinic care coordinators.

1. General Job duties:

Risk assessment on all patients, flag patients for Social Work with psycho/social complexity, coordinate with provider, therapy, social worker, nursing and transitional care associate on discharge planning/care coordination; coordinate placement for post-acute care, document daily updates in medical record, complete EMS transfer forms with clinical information.

• Participates in utilization management, discharge planning, patient throughput, and evaluates the appropriate use of hospital resources by ensuring that patients meet medical necessity during their hospitalization

• Utilizes the organizational approved references and software programs to assess medical necessity

• Responsible for managing payer relations and requirements to achieve optimum reimbursement and patient outcomes

• Reviews documentation for quality assurance and clinical validation

• Ensures CMS discharge standards are achieved

• Provides case management in collaboration with the medical staff, nursing, and ancillary departments throughout the hospital to ensure a safe, timely, transition to the appropriate level of care

• Familiar with standard concepts, practices, and procedures within the field

• Relies on experience and judgment to plan and accomplish goals

• Regular and predictable attendance is an essential job function

• Competent to meet age specific needs of the unit assigned

2. Equipment utilized in the unit/dept : Computer

3. Required skills and minimum years of experience :

Minimum of 2 years' experience in acute care hospital Case Management and discharge planning

Strong Communication Skills

Electronic Medical Record experience

4. Specific licensures and certifications/registrations required :

Idaho/compact RN license, active and in good standing

BSN

BLS

CCM/ACM preferred

5. Shift or schedule requirements:

40 hours per week, 8:00-4:30 M-F with rotating weekends. No Call.