RN - Case Manager

SSM Health - Bridgeton, MO (24 days ago)3.8


Description

Role Purpose:
Evaluates insurance coverage while managing the utilization review process from admission to discharge. Completes and updates medical records pertaining to case management and authorizations. This position
participates in a multidisciplinary palliative care team.

Responsibilities:
Joins with treatment team in reviewing comprehensive patient/ family treatment plan.
Collaborates with physicians and other health care professional regarding patient plan of care and intermediate care goals within proposed time line.
Reviews and evaluates discharge planning on all clients while scheduling follow-up appointments.
Evaluates insurance coverage for optimal use of benefits while managing the utilization process from admission to discharge.
Interviews patient / family members, obtain a complete initial social history including financial information, and communicate with external case managers to receive authorization of payment.
Performs all other duties according to entity policies/procedures as assigned.

Qualifications

Minimum Qualifications:
Associate Degree or Diploma School Program
Required -State of Missouri Nursing License; Preferred – BSN and UR, QA, or CM certification
1 to 3 years of experience.
SSM Health DePaul Hospital – St. Louis –

SSM Health DePaul Hospital is a 476-bed hospital offering comprehensive medical services, including inpatient and outpatient surgeries using state-of-the-art technology and facilities. Opened in 1828, DePaul Hospital - St. Louis was the first hospital west of the Mississippi River and remains the oldest continuously existing business in St. Louis. DePaul Hospital serves patients from across the St. Louis metropolitan area, including the communities of Bridgeton, Florissant, Hazelwood, St. Ann, St. John, Maryland Heights and Overland.

Benefits Statement:
Our robust employee benefits package includes health benefits, life and accidental death and dismemberment insurance, long-term disability coverage, health and dependent care reimbursement accounts, paid time off, tuition reimbursement, adoption reimbursement, an employee assistance program, retirement plan options and more.

Note: not all benefits apply to all openings.