RN Care Manager - Utilization Review

LCMC Health; Louisiana; On-site; USD 65,000 - 85,000; Full time

Job summary

LCMC Health in Louisiana seeks a Care Manager to serve as the hub of patient case management and care planning. You will coordinate care across the care team and implement the plan of care to achieve optimal patient outcomes and efficient resource use.

Responsibilities include outbound calls to assess health status, coordinating care and referrals, discharge planning with medication reconciliation, enrolling patients in home monitoring programs, and documenting workflows in EPIC.

Qualifications

• Active nursing license to practice in Louisiana.
• Minimum 2 years of professional nursing or care management experience.
• Experience in coordinating care and communicating with care teams.

Responsibilities

• Make outbound calls to assess patient health status.
• Coordinate care for members and arrange referrals.
• Ensure discharge planning with necessary services and medication reconciliation.
• Enroll patients in home monitoring programs and manage alerts.
• Provide approved health information and guidance to public callers.
• Document workflows in EPIC for tracking and quality assessment.
• Provide patient education to aid self-management.
• Collaborate with care partners, leadership and physicians on care plans.

Skills

Care coordination

Nursing knowledge

Education

Licensed Registered Nurse (LA)

Tools

EPIC

Job description

Your job is more than a job You overthink every care option and scenario because, as a Care Manager, you are the hub of your patient's case management and care plan. You assure quality through the continuum of care, collaborate with members of the care team, and implement the plan of care and transition strategies. Achieving the best possible patient outcomes, appropriate length of stay, efficient utilization of resources, coordination of patient, family, and staff communication and education is the center of your nursing universe.

Gatekeeper, facilitator and decision-maker, and hand-holder, you apply nursing knowledge, logic, and a little "extra" heart into everything you do. And we're excited to get to know you and find out what you'll bring to this case management nursing role.

Develop individualized care plans, including prioritized goals, that consider the patient's and caregivers' goals, preferences and desired level of involvement in the care management plan.

• Make outbound calls to assess patient's current health status.
• Coordinate care for members and makes referrals to outside sources.
• Ensure members discharging from hospital or emergency department receive the necessary services and resources, including medication reconciliation.
• Enroll patients and manage alerts for various home monitoring programs.
• Provide approved general health information and guidance to public caller from approved sources by assessing needs of the caller.
• Document all workflows in EPIC system for purposes of tracking and quality assessment.
• Provide patient education to assist with self-management of wellness and disease.
• Interact with LCMC Health care partners, leadership and/or physicians to discuss clinical questions, concerns, strategies, and care plans to achieve quality and cost management objectives.
• Demonstrate energy, excitement, and a passion for quality work.
• Current nursing license to practice in Louisiana and as defined by the Louisiana State Board of Nursing.
• 2 years of professional nursing or care management experience.

WORK SHIFT:

Days (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.

Deliver healthcare with heart.

Forget one-size-fits-all, think one-of-a-kind care.

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.

LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.

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

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.

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.