mcbg6335

They use interqual.....

Im new to CM.My new job description include:"Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient. Responsible for educating and motivating employees to participate in wellness programs. Support health promotion and disease prevention and care management services. Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained. Manages own caseload and coordinates all assigned cases..." .It sounds like a mix of UM and CM,and I am.excited.What is a typical day like for those of you with a similar job description?What was the hardest part?How did you make sure you were knowledgeable about the diseases of your clients,especially if it was an area you did not have much clinical exposure to at bedside? This was my dream job and company,and I am so nervous,because ive only worked at SNF,nothing exciting at all,just med passes and a wide range of elderly sick residents.I hope I can do this,please share any advice,warnings,etc.Thanks.

Can you plse list the federal and state website that you referred to? Also, what are some good references to have on hand, as you also mentioned? Thanks so much!

I just got offered a case manager job at an insurance company thru a recruiter and the pay is great, so much so I am a little suspicious even! Its a contract to hire position for 4 months, maybe that's why?I was told they liked my experience at skilled nursing facilities/home.What would a case manager do at a nursing home, visit patients on their medicare/medicaid plans? how do they benefit? There's been such an increase for this role due to the Affordable care Act, it seems. What tips advice does anyone have for a new case manager? Do I need to brush upon my knowledge of various diseases, etc, and bring out my 300 page nursing books from eons ago? I want to make sure I do very well so that after 4 months they hire me perm.

Hi, I am happy to announce that after many years of being miserable as a nurse, I am LEAVING! I've worked at crappy, unprofessional, smelly, ghetto, you name it nursing homes the past 5 years.I was just waiting until my kids began school to leave.I worked so long and hard to finish nursing school, and like many others, believed the lies my teachers told me about how great a field it is.Yeah, right.I tried to get a "desk" job as a nurse, they all want years of experience in a hospital.Hospitals don't hire ADN nurses, although I already have a non nursing Bachelors, I did not want to spend more money getting a BSN OR MSN. My husband doesn't get it really, thinks I'm crazy to leave, but hes not a nurse! I am interviewing now for some great jobs in the corporate world, no weekends, holidays, nights, urine, CNA's who think they are nurses....need I go on, I'm sure I'm not alone. Taking a GIANT pay cut, but I am so happy! That's priceless.