Job Title: Case Manager RN
Profession: Registered Nurse
Specialty: Case Manager
Duration: 13 weeks
Shift: Day
Hours per Shift: 8 hours (08:00 - 16:30)
Experience: 5+ years of RN Case Management experience
License: CA RN License
Certifications: BLS
Must-Have: Must have discharge planning experience and inpatient acute case management experience.
Description:
Responsible for care coordination and care transitions planning throughout the acute care patient experience.
This position works in collaboration with the physician, utilization manager, medical social worker, and bedside RN.
The goal is to assure the timely progression and transition of patients to the appropriate level of care to prevent unnecessary admissions or readmissions.
The care management process encompasses communication and facilitates care across the continuum through effective resource coordination.
The objectives include achieving optimal health, access to care, and appropriate utilization of resources while balancing patient self-determination.
Collaboration occurs with patients, families, physicians, interdisciplinary teams, nursing management, quality departments, and community resources.
If assigned to the emergency department, the focus is on efficiently addressing complex clinical and social situations to avoid unnecessary admissions.
Job Duties:
Conduct patient initial and continued assessments.
Review initial physician admission care plans.
Gather additional medical, psychosocial, and financial information from patient and family interviews, medical records, and healthcare providers.
Determine moderate or high-risk levels for readmission.
Screen for ancillary supportive service needs.
Lead the healthcare team in developing comprehensive cost-effective care coordination plans.
Identify and refer quality and risk management concerns for patient safety reporting.
Direct and oversee the case management assistants in determining preferences for post-acute care services.
Utilization management includes reviewing medical records to ensure patients meet level of care requirements.
Work with attending physicians to confirm necessary documentation.
Expedite transition planning for patients who no longer require acute care.
Monitor length of stay and address outliers requiring additional resources.
Formulate transition plans after reviewing care options and obtaining input from patients, families, and healthcare teams.
Document and communicate assessment findings effectively to the healthcare team.
Proactively identify barriers to care progression and work with the multidisciplinary team to resolve them promptly.
Address complex clinical and social situations efficiently.
Actively participate in ongoing department operations and contribute to creating cost-effective practices.
Communicate effectively with colleagues to promote customer service.
Develop and maintain positive professional relationships with the healthcare team and community agencies.
Engage constructively in all department operations and provide feedback to colleagues and leadership.
Utilize effective communication skills with colleagues to resolve issues in a timely manner.