Inpatient Case Manager, Emory Saint Joseph, Full Time
On-site · Marietta, Georgia, United States
Job Summary
Inpatient Case Manager responsible for collaborating with physician partners to optimize quality and efficiency of care for hospitalized members. Performs daily utilization and quality review, monitors for care inefficiencies, and develops safe discharge plans including recommendations for alternative levels and sites of care. Conducts chart reviews, discusses care with attending physicians, reviews new inpatient admissions within 24 hours, coordinates discharge planning, identifies patients for ambulatory case management, communicates with case managers, social workers, members and providers, and supports quality improvement initiatives. Delivers education to members/families, providers, and hospital staff; documents admissions/discharges in Kaiser Permanente EMR; participates in rounds with the Physician Director of Resource Stewardship; coordinates transitions between levels of care and ensures compliance with applicable laws and regulations. Requires strong communication, problem-solving, critical thinking, and clinical judgment as part of a multidisciplinary health care team; prioritizes timely, efficient, and appropriate resource use and patient-centered care.
Required Qualifications
- Minimum two (2) years of RN experience in patient care delivery or completion of Masters degree in Case Management Program in lieu of minimum years of experience.
- Education: Associates Degree Nursing.
- License, Certification, Registration: Registered Professional Nurse License (Georgia)
- Excellent communication and interpersonal skills with all levels of internal & external customers
- Ability to collaborate effectively with multidisciplinary healthcare team
- Knowledge of healthcare benefits and managed care delivery including Medicare
- Experience with Kaiser Permanente electronic medical record (EMR) and post-discharge follow-up processes
- Knowledge of relevant federal/state/local regulations (HIPAA, EMTALA, CMS, NCQA, TJC, DMHC)
- Awards/credentials: Complex Case Management Certification preferred
- Notes: Work Schedule details and location: Marietta, GA; US
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