Registered Nurse Case Manager
1 week ago
Performs integrated patient care quality monitoring: Utilizes Medical Staff approved comprehensive monitors that measure/evaluate: o Operative and Invasive procedures o Peri-natal o Infection Control o Stability at Discharge o Utilization o Case Review Immediately notifies the Quality and Accreditation Improvement Department of urgent/critical quality issues.
Identifies cases for potential peer review and reports these cases to the Quality and Accreditation Department. Documents all screening and outcome variations according to Quality & Accreditation Department process. Utilizes Medical Staff approved monitors for ongoing measurement/evaluation of utilization management.Maintain current clinical records according to department policy and professional standards and prepares monthly statistical reports.
Is available on a rotating basis on weekends, evenings, and holidays with other staff to provide onsite services from utilization review.
Readily distinguishes between acute, intermediate and skilled levels of care. Contacts managed care companies on a daily basis to assure reimbursement for continued stay.Documents assessment, discharge plan, problems, services, and outcomes in the medical record in a clear and concise manner with consideration of the patient's age, developmental needs, diagnosis and employee area of specialization.
Makes referrals and arranges for needed services for home careAssists the patient and significant other in assessing discharge options and determining a plan for continuing care within the limits of resources, personal preferences, regulations, and medical needs.
Makes appropriate referrals to Pastoral Care to meet the spiritual needs of our patients and significant other. Makes appropriate referrals to community action groups, support groups, etcetera. Complies with the State law for reporting abuse/neglect for children and adults.Completes a psychosocial history and assessment for patients identified as high risk that is maintained as a permanent part of the medical record.
Identifies high risk patients (through predetermined screening criteria) and makes prompt appropriate referrals to social services/social workers. Maintains confidentiality in accordance with hospital policy. Maintains open communication with MSMHC staff,Serves as patient advocate in assuring a collaborative approach to patient care management.
Medical Staff, patients, significant others, nursing and health care providers as appropriate, (internal and external) to facilitate the case management process and enable patients to make informed decisions regarding their plan of treatment and discharge disposition
Participates in improving processes related to the Continuum of Care, Performance Improvement, and The Joint Commission Important Functions as appropriate.
Participates in the formulation and revision of policies and procedures related to the case management process.Attends required departmental staff meetings. Participates or provides at least one educational program annually for SMHC staff. Associate's degree in Nursing required
Bachelor's degree in Nursing preferred
Ability to comprehend and follow the policies and procedures for MedStar Southern Maryland Hospital Center.
Ability to read, write and speak or communicate in English to successfully accomplish the essential duties of the position.
Ability to demonstrate ethical behavior that supports the hospital's mission, values and commitment to compliance with all federal, state and regulatory laws.
Knowledgeable of MedStar Southern Maryland Hospital Center's performance improvement priorities and outcomes.Demonstrate initiative in acquiring knowledge to further understand the overall department and hospital functions.
Ability to demonstrate responsibility for work performance, consistent good attendance, and resourcefulness to solve case management problems.
Knowledge and ability to use a desktop/laptop computer.
Why MedStar Health?
At MedStar Health, we understand that our ability to treat others well begins with how we treat each other. We work hard to foster an inclusive and positive environment where our associates feel valued, connected, and empowered. Strategic focus on equity, inclusion, & diversity - we are committed to equity for all people and communities.
We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
Comprehensive total rewards package - including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
More career opportunities closer to home - as the largest healthcare provider in the Baltimore-Washington, D.About MedStar HealthMedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.region, while advancing the practice of medicine through education, innovation, and research.
Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation.
As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team.
Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities.
MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees.We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations.
MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws.
If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.
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