PRINCIPAL DUTIES AND RESPONSIBILITIES:
1. Activates a process for each patient and uses a case management plan in managing care consistent with predetermined financial and quality outcomes, in collaboration with physicians and other healthcare members and payors.
2. Establishes collaborative practices with nursing, physicians, and health care professionals regarding plan of care, variances in plan implementation, and outcomes or expected outcomes.
3. Assesses, gathers information on physical, psychosocial, spiritual functioning, coping abilities, available resources, and support systems. Identifies potential or actual health problems, establishes nursing diagnosis, formulates plan and nursing intervention during inpatient stay, and plans for discharge. Facilitates transition of care to appropriate level of care and facility.
4. Manages and/or delegates care for case load during the patient health care continuum or episode of care. Facilitates communication with all departments. Collaborates for timely outcomes; prevents duplication and fragmentation of services. Assesses educational needs of staff and provides appropriate education.
5. Is responsible for internal and external patient care standards. Identifies and documents incidents that may affect quality of care. Tracks and reports on variances to department. Maintains documentation of case management activities, plans, and outcomes.
1. The level of knowledge equivalent to that ordinarily acquired through completion of a BSN. Current licensure to practice nursing in the Commonwealth of Massachusetts. 2. A Minimum of 3 years of RN experience in an acute care hospital environment with a minimum of 3 years experience in acute care, community nursing, and utilization review or related area.
Hospital Case Management experience strongly preferred
Registered Nurse Certified