RN Case Manager -Acute Rehab Unit, Full Time 8 Hours ...

ESSENTIAL JOB FUNCTIONS AND CORE RESPONSIBILITIES•Actively participates in clinical performance improvement activities.•Applies approved InterQual criteria to monitor appropriateness of admissions and continued stays and documents findings based on department standards.•Assist in the compilation of physician profile data regarding LOS, resource utilization, denied days, cost, case mix index, patient satisfaction, and quality indicators.•Assists in the collection and reporting of financial indicators including case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials, and appeals.•Collaborates and communicates with multidisciplinary team in all phases of discharge planning process, including initial patient assessment, planning, implementation, interdisciplinary collaboration, teaching, and ongoing evaluation.•Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting.•Collaborates with the physician and all members of the multidisciplinary team to facilitate care for designated caseload; monitors the patient's progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient, and cost effective; facilitates the following on a timely basis: completion and reporting of diagnostic testing, completion of treatment plan and discharge plan, modification of plan of care, as necessary, to meet the ongoing needs of the patient, communication to third-party payers and other relevant information to the care team, assignment of appropriate levels of care, completion of all required documentation in Affinity GUI screens and patient records•Collaboratescommunicates with external case managers.•Collects delay in service data and data for specific performance andor outcome indicators as determined by the director.•Communicates with Financial Counselor to facilitate covered day reimbursement certification for assigned patients. Discusses payer criteria and issues on a case-by-case basis with clinical staff and follows up to resolve problems with payers as needed.•Completes utilization management for assigned patients.•Coordinatesfacilitates patient cares progression throughout the continuum.•Documents relevant discharge planning information in the Affinity GUI System according to department standards.•Ensures that all elements critical to the plan of care have been communicated to the patientfamily and members of the health care team and are documented as necessary to ensure continuity of care.•Ensuresmaintains plan consensus from patientfamily, physician, and payer.•Facilitates transfer to other facilities.•Identifies at-risk populations using approved screening tool and follows established reporting procedures.•Initiates and facilitates referrals to the Home Health Liaison for home health care, hospice, and medical equipment and supplies.•Issues Notices of Non-coverage per hospital policy.•Manages all aspects of discharge planning for assigned patients.•Meets directly with patientfamily to assess needs and develop an individualized plan in collaboration with the physician.•Monitors all transfer DRG's.•Monitors length of stay (LOS) and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in bothJOB REQUIREMENTSEducation: Minimum (Required)Bachelor's degree in nursingLicenseMinimum (Required)•A current RN licensure in the State of California is required.•Must successfully complete and maintain BLS certification.Preferred (Not required)Professional certification as a case manager preferred.USC is a smoke-free environmentUSC is an equal opportunity, affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other characteristic protected by law or USC policy. USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations, including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance, and with due consideration for patient and student safety. Please refer to the Background Screening Policy Appendix D for specific employment screen implications for the position for which you are applying. We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone at (213) 821-8100, or by email at . Inquiries will be treated as confidential to the extent permitted by law.Read USC's Clery Act Annual Security ReportAffirmative Action and Equal Opportunity PlanPay Transparency Non-DiscriminationUSC is an E-Verify EmployerDigital AccessibilityIf you are a current USC employee, please apply to this USC job posting in Workday by copying and pasting this link into your browser:

Created: 2025-02-19