[Hiring] Utilization Review Nurse @LCMC Health

Role Description

Your job is more than a job. As a Care Manager, you’re 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 is at the center of your nursing universe.

Your Everyday:

• 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.
• Identify gaps or barriers in treatment plans.
• Coordinate care for members and make referrals to outside sources.
• Ensure members discharging from hospital or emergency department receive the necessary services and resources, including medication reconciliation.
• Triage symptom-based calls per approved protocols for a wide range of patients.
• Enroll patients and manage alerts for various home monitoring programs.
• Provide approved general health information and guidance to public callers 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.
• Educate enrolled members on chronic and acute disease processes.
• 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.

Qualifications

• 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.

Requirements

• Variable Hours (United States of America)

Benefits

• Deliver healthcare with heart.
• Give people a reason to smile.
• Put a little love in your work.
• Be honest and real, but with compassion.
• Bring some lagniappe into everything you do.
• Forget one-size-fits-all, think one-of-a-kind care.
• See opportunities, not problems – it’s all about perspective.
• Cheerlead ideas, differences, and each other.
• Love what makes you, you - because we do.