RN Case Manager - St. Mary

Job Overview

This role involves multi‑disciplinary communications and facilitation of care throughout a patient’s hospitalization. The duties include reviewing resource utilization, balancing it with the patient’s right to self‑determination, recommending medically necessary levels of care, confirming specific care orders, and ensuring appropriate documentation in the medical record. The RN may discuss alternative care options with ED or attending physicians, acts as a liaison among patients, caregivers, multidisciplinary team members, and post‑acute / third‑party payers, and collaborates with the care team to develop and implement individualized discharge plans.

Key Responsibilities

• Perform pre‑admission, admission, and continued stay reviews per CMS guidelines, commercial payer guidelines, and hospital policy.
• Maintain the values of Service Excellence, Teamwork, and Integrity while meeting licensure standards and pursuing professional development.
• Maintain knowledge of the Conditions of Participation related to utilization review and discharge planning.
• Maintain open communication with all appropriate parties while functioning as a liaison between ED physicians, hospitalists, attending physicians, and Physician Advisors.
• Lead the oversight and management of functional and financial outcomes, coordinating and implementing the discharge plan during acute‑care hospitalization.
• Adapt communication style and explanations of services to the specific patient population, respecting privacy and ensuring clear, professional presentation.
• Perform other related duties as required.

Education

• Required: Registered Nurse diploma or equivalent.
• Preferred: Bachelor’s degree in Nursing.

Work Experience

• Required: 3 years of hospital‑based experience.
• Preferred: Experience in discharge planning, case management, or utilization review.

Certifications

• Required: Current State of Louisiana Registered Nurse license.
• Required: Basic Life Support (BLS) certification from the American Heart Association.
• Preferred: Case Management (CCM) or Accredited Case Manager (ACM) certification.

Knowledge, Skills, and Abilities (KSAs)

• Computer skills and dexterity for data entry and retrieval of patient information.
• Proficiency with Windows‑style applications and keyboard use.
• Effective verbal and written communication skills and the ability to present information clearly and professionally to varied audiences.
• Strong interpersonal skills.

Physical and Environmental Demands

Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects.
Existing conditions include walking or standing to a significant degree, pushing or pulling of arm or leg controls, and maintaining a production rate pace which may involve constant pushing or pulling of materials even if their weight is negligible. Mechanical lifting devices (carts, dollies, etc.) and team lifts should be utilized. The RN must be able to stand for prolonged periods, work a flexible schedule, and may be exposed to blood, body fluids, and tissues. The position involves a patient care area, direct patient contact, and handling of specimens that may contain communicable diseases.

Equal Opportunity Statement

Ochsner is an Equal Opportunity 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, or disability status.