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The Care Manager – ER collaborates with the emergency department team to assess potential admissions and determine appropriate status placement using evidence-based criteria such as MCG or third-party review tools. This role supports efficient patient flow by avoiding unnecessary admissions and guiding at-risk patients and families to appropriate community-based resources. The Care Manager – ER facilitates transitions of care, supports discharge planning, and ensures regulatory and documentation requirements are met for patients entering hospice or post-acute services.
Essential Functions
- Assesses patients in the emergency department for medical necessity of admission and ensures correct placement into inpatient, observation, or outpatient status using MCG or approved criteria.
- Identifies patients who may be appropriate for alternative care settings and works to avoid unnecessary or social admissions by coordinating with community resources.
- Provides timely guidance and education to patients and families regarding care transitions, including hospice services or post-acute facility placement, and secures patient choice documentation as required.
- Verifies next of kin contact information and ensures accurate documentation on patient records.
- Collaborates with ED clinicians, hospitalists, case managers, and social services to support seamless transitions of care.
- Performs other duties as assigned.
- Maintains regular and reliable attendance.
- Complies with all policies and standards.
- Bachelor's Degree in Nursing (BSN) preferred
- 1-3 years of experience in an acute care or hospital setting required
- 1-2 years of experience in care management or utilization review preferred
- Knowledge of admission criteria and care level determination tools such as MCG or InterQual.
- Strong clinical assessment and decision-making skills.
- Ability to effectively coordinate community-based services and discharge planning.
- Excellent communication and interpersonal skills for patient and interdisciplinary team interactions.
- Strong organizational skills with attention to detail and compliance documentation.
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required
- BCLS - Basic Life Support preferred
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