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Job Title/
Job Number:
CASE MANAGER ED (Emergency Department), Full-time, 3:00PM - 11:00PM
139295
Job Details: Reviews all Emergency Department patients who are identified by the ED Physician as requiring admission to the hospital in order to: 1. confirm the diagnosis identified as the reason for admission; 2. confirm that the clinical symptoms of the patient meet InterQual and/or Milliman And Robertson criteria for admission; and 3. confirm that the defined level of care/status is appropriate for the identified treatment plan. Provides consultation to the Registration staff in regard to appropriate bed assignment for all ED admissions, direct admissions or transfers to the hospital. Identifies ED patients whose insurance plans may be out-of-network and works with the patient s primary care physician and ED physician to either precertify admission or transfer the patient to an appropriate health care facility. Enters initial UM clinical review on ED admissions and follow-up on observation patients to assure discharge or conversion to inpatient if medically appropriate. Reviews all one day stay admission for appropriate status and provides clinical review to outside review agencies for these patients as requested.
 
  • Bachelor’s degree preferred.
  • Current RN licensure in Illinois. 
  • 5 or more years’ medical/surgical-nursing experience preferred. 
  • Prior experience in Utilization Management or Case Management required.
  • Administrative skills. 
  • Ability to communicate effectively in English, both verbally and in writing. 
  • Ability to use various instruments, machines, tools, equipment and work aids as necessary to perform job duties. 
Job Category: Administrative / Business Support
Organization: Adventist Bolingbrook Hospital
Location: US-IL-Bolingbrook
Schedule: Full-time
Shift: Evening
Job Level: Staff / Associate
Education
Level:
Associate's Degree
Travel: No
Posting Date: Nov 14, 2012
     
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