Care Management Coordinator
4 weeks ago
This Care Management RN provides comprehensive care coordination of patients as assigned. The Care Management RN assesses the patient's plan of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through their care, facilitating options and services to meet the patient's health care needs. The intensity of care coordination provided is situational and appropriate based on patient need and payer requirements. This position is accountable for the quality of clinical services delivered by both them and others and identifies/resolves barriers which may hinder effective patient care.
This position has responsibility to determine how to best accomplish functions within established procedures, consulting with leader on any unusual situations. Internal customers include all levels of nursing management and staff, medical staff, and all other members of the interdisciplinary health care team. External customers include physicians and their office staff, payers, community agencies, provider networks, and regulatory agencies.
** Casual RN Position** Must be able to work a minimum of 2 shifts per month
Responsibilities Job Description
Job Expectations:
- Manages patients across the health care continuum to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
- Acts as one point of contact for patients, physicians and care providers throughout the patient's hospitalization.
- Initiates/implements transition functions and activities for patients communicating with patients, families and the health care team to ensure seamless transitions.
- Assesses patient admissions and continued stay utilizing evidence based criteria.
- Contributes to the development and implementation of individualized patient care plans.
- Collaborates with health care team partners and patients/family to manage the patient discharge plan.
- Effectively communicates the plan across the continuum of care.
- Assist in the development and implementation of process improvement activities to achieve optimal clinical, financial and satisfaction outcomes.
- Enables efficiency in care by identifying and reducing delays, ensuring appropriate level of care, facilitating length of stay reductions and identifying resources to promote a safe and effective discharge.
- Collects data and other information required by payers to fulfill utilization and regulatory requirements.
- Identify and communicate, to appropriate leader, all issues related to case escalation.
- Establishes a collaborative relationship with physicians, medical directors, nurses and other unit staff, and payers.
- Demonstrates effective communication by being a critical link with attending and consulting physicians and all health care team members and payers. Facilitates resolution to any identified issues.
- Mentors internal members of the health care team on case management and managed care concepts.
- Understands and focuses on key performance indicators.
- Actively tracks outcomes and participates in quality planning.
- Facilitates integration of concepts into daily practice.
- Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served
- Partners with patient care giver in care/decision making.
- Communicates in a respectful manner.
- Individualizes plan of care to meet patient needs.
- Modifies clinical interventions based on population served.
- Provides patient education based on as assessment of learning needs of patient/care giver.
- Fulfills all organizational requirements
- Completes all required learning relevant to the role
- Complies with all relevant laws, regulation and policies
- Performs other duties as assigne
Required
- Associate's Degree in Nursing
- 5 years clinical experience
- 1+ years working as a care coordinator/case manager
- Active MN Registered Nurse license
- BSN
- Case Management Certification
A person in this role must:
- Have an understanding of hospital, community resources and resource/utilization management.
- Have working knowledge of use of evidence based guidelines.
- Demonstrate critical thinking skills, problem-solving abilities, effective communication skills and time management skills.
- Demonstrate ability to work effectively on an interdisciplinary team.
- Have familiarity with computer systems and Microsoft applications.
- Be available/able to work flexible hours, including covering weekends, and work on call as assigned.
EEO Statement
EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status
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