Monitors and manages patient care to promote continuity of care, optimal patient outcomes, patient satisfaction, cost efficiency and compliance.

Consults with nursing staff and multidisciplinary team regularly to evaluate patient's status and appropriateness of medical care, including admission, length of stay, transfer and discharge.  Monitors patient and family satisfaction. Responds to questions and complaints from patients, family members, and payors regarding care.  Participates in discharge planning including coordinating patient transfers to other facilities and coordinating community resources. Provides discharge education and resource referrals to patients.  Performs chart review to identify actual or potential issues with service delivery, patient outcomes and satisfaction, compliance, cost, and reimbursement.  Performs intake assessment on patient within 24 hours of admission.  Reviews patient care activities for occurrences and trends that affect the quality, cost effectiveness, and delivery of services. Assures that the outcome of review is appropriately maintained in the computer database.  Assumes responsibility for timely completion of required case management reports for regulatory bodies, health plans, reinsurance carriers, and the PMG/ IPA Board of Directors.  Functions as a patient/ family advocate.  Maintains optimal continuum of patient care through efficient and effective planning, assessing and coordination of healthcare services.  Establishes and maintains efficient methods of ensuring the medical necessity and appropriateness of all hospital admissions.  Performs concurrent reviews for patients to ensure that extended stays are medically justified and are so documented in patient's medical records.  Calculates the length of stay and continued stay days for patients.  Maintains a liaison with the social service department to facilitate timely discharge planning.

Minimum Education
High School diploma, GED or equivalent required.
Associate's Degree preferred.
Bachelor's Degree preferred.
Master's Degree preferred.

Minimum Work Experience
1 or more years case management experience preferred
2 or more years acute hospital, home health, hospice, inpatient mental facility experience preferred

Required Licenses
Must have a current Mississippi Registered Nurse license or a current Compact State Registered Nurse license

Required Skills
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.

Current American Heart Association Basic Life Support (BLS) certification required within 90 days of hire or transfer.  

About Bolivar Medical Center

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