RN Case Mgr Weekend Per Diem
2 weeks ago
Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.
The RN Case Manager bears overall responsibility for coordinating patient care activities to ensure that care meets evidence-based practice standards, and regulatory/payer requirements. The role integrates and coordinates utilization management, care coordination, and discharge planning functions. RN Case Managers may work in units such as ETD, Observation, PACU or in any other area of HackensackUMC as deemed appropriate by the leadership of the department. Shift and weekend rotation as needed. The RN Case Manager is accountable for a designated patient caseload and plans effectively in order to meet patient needs, manage the length of stay, and promote efficient utilization of resources. Specific functions within this role include:
- Facilitation of the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement
- Application of process improvement methodologies in evaluating outcomes of care
- Coordination of communication with physicians, nursing, and staff of ancillary departments
- Evaluation of care provided against the Length of Stay
- Collaboration with Admitting to ensure accuracy of patient demographic and insurance information
- Communication with patients and their families around medical plan of care and discharge plan
- Assessment and plan for discharge needs and arrangements, including leading multi-disciplinary care conferences and morning 'flash meetings' in conjunction with Nursing.
- Coordinates/facilitates patient care progression throughout the continuum.
- Works collaboratively and maintains active communication with physicians, nursing, and other members of the multidisciplinary care team to effect timely and appropriate patient management.
- Identifies and resolves delays and obstacles to discharge in a proactive manner. Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting.
- Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge.
- Utilizes advanced conflict resolution skills as necessary to ensure timely resolution of issues.
- Collaborates with the physician and all members of the multidisciplinary team to facilitate care for designated caseload; monitors the patient's progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient, and cost effective; facilitates the following on a timely basis:
- Communication of all elements critical to the plan of care to the patient/family and members of the health care team.
- Completion and reporting of diagnostic testing.
- Completion of treatment plan and discharge plan.
- Modification of plan of care, as necessary, to meet the ongoing needs of the patient
- Communication to third-party payers and other relevant information to the care team
- Assignment of appropriate levels of care vii) Completion of all required documentation in the IT Case Management screens, and patient records
- Completes utilization management for assigned patients.
- Applies approved InterQual criteria as a guideline to monitor appropriateness of admissions and continued stays and documents findings based on department standards.
- Identifies at-risk populations using approved screening tool and follows established reporting procedures.
- Monitors length of stay (LOS) and clinical resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas.
- Refers cases and issues to physician advisor in compliance with department procedures and follows up
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