RN - Case Manager

Overview:

Works with physicians and multidisciplinary team members to develop a plan of care for assigned patients Ensures patient is progressing towards desired outcomes by monitoring care through assessments and/or patient records Identifies and resolves barriers that hinder effective patient care

Actively involved in discharge planning process

Responsibilities:

• Promotes patient, staff, physician, payer and organizational satisfaction by coordinating and facilitating the delivery of quality care while focusing on productivity and the utilization of resources.
• Works cooperatively and collaboratively with the healthcare team across the continuum of care to ensure that the patient receives high quality and cost effective care. Discharge in an appropriate and timely manner is a goal.
• Conducts timely patient assessments, admission, continued stay and discharge criteria reviews.
• Responds to the requests of third party payers, home health care and hospice agencies, home medical equipment companies, outside case managers, emergency room, ambulatory services, clinics, retirement center and live-in services, etc. and assists with the planning, implementation, coordination, and delivery of services as warranted.
• Facilitates the navigation of the patient through the complex healthcare system focusing on the removal of barriers that obstruct delivery of care or the provision of services. Intervenes as necessary to ensure that patient outcomes, satisfaction and goals are achieved.
• Identifies variances in care and explores opportunities to minimize those variances. Reports possible risk or quality of care issues to the Manager of Quality Services.
• Monitors progress, process and quality of care in the following areas:
• Assessment: gathers, revises and monitors a wide range of information pertaining to the clients socioeconomic, health, functional, environmental care requirements, educational needs, family and community support and family/patient goals and preferences and needs for continuing care. Any available source is used to ascertain the above mentioned areas whether it be patient/family, physician, friends, relatives, minister, outside agency or other record.
• Planning: determines actions and needs necessary to meet the patient, family, and physician goals and objectives as warranted.
• Implementation: initiates, modifies and completes activities that ensure the accomplishment of the goals for the indicated situation in a timely and effective manner.
• Coordination: assures that the plan/needs are organized, scheduled and revised in a timely manner so that they will aid in the accomplishment of the organizational plan
• Monitoring: assures that case management activities provide the necessary information to determine the effectiveness of the plan.
• Evaluation: assures that a process is in place to look at particular concerns to assure that the plan accomplishes the desired/planned outcome and goals.
• Follows the practice guidelines for Case Management as set forth by the Case Management Society of America.
• Negotiates effectively for the provision, cost or the availability of services without compromising the well-being of the patient.
• Communicates effectively with the patient, family members and all members of the healthcare team and outside resources.
• Evaluates the case management process as an ongoing process, identifies opportunities for improvement and implements process changes as needed.
• Age Specific Knowledge and Competencies:
• Demonstrates and applies knowledge of human development and of the potential for human growth,
• Demonstrates knowledge of the principles of growth and development over the life span to assess age-specific needs of the patient and provide for the appropriate care
• GENERAL:
• Able to recognize indicators of domestic violence, elder abuse, child abuse, child neglect, and sexual assault and makes appropriate referrals.
• Able to counsel the patient and family members regarding issues of death and dying.
• NEONATE: Knowledgeable of normal newborn and on assessment recognizes deviations from normal and integrates into the plan of care and/or discharge plan. Knowledgeable of case management interventions which are appropriate for age group. Involves parents or guardians in decision making. Educates parent or guardians in needed aspects of care/discharge planning. Familiar with the special needs of the newborn and can access appropriate resources.
• INFANT: Knowledgeable of growth and development for age group and emotional, cognitive, educational, social and daily activity needs. On assessment recognizes deviation from normal and integrates into the plan of care and/or discharge plan. Knowledgeable of case management interventions appropriate for age group. Involves parents or guardians in decision making. Educates parents or guardians in needed aspects of care/discharge planning. Familiar with the special needs of the infant and can access appropriate resources.
• TODDLER: Knowledgeable of growth and development for age group and emotional, cognitive, educational, social and daily activity needs. Uses methods of communication appropriate to age group. Uses teaching techniques appropriate to age group. On assessment recognizes deviation from normal and integrates into the plan of care and/or discharge plan. Knowledgeable of case management interventions appropriate for age group. Involves parents or guardians in decision making. Educates parents or guardians in needed aspects of care/discharge planning. Familiar with the special needs of the toddler patient and can access appropriate
• PRESCHOOLER: Knowledgeable of growth and development for age group and emotional, cognitive, educational, social and daily activity needs. Uses methods of communication appropriate to age group. Uses teaching techniques appropriate to age group. On assessment recognizes deviation from normal and integrates into the plan of care and/or discharge plan. Knowledgeable of case management interventions appropriate for age group. Involves parents or guardians in decision making. Educates parents or guardians in needed aspects of care/discharge planning. Familiar with the special needs of the preschooler patient and can access appropriate resources.
• SCHOOL AGE: Knowledgeable of growth and development for age group and emotional, cognitive, educational, social and daily activity needs. Uses methods of communication appropriate to age group. Uses teaching techniques appropriate to age group. On assessment recognizes deviation from normal and integrates into the plan of care and/or discharge plan. Knowledgeable of case management interventions appropriate for age group. Allows the child to participate in his/her care. Involves parents or guardians in decision making. Educates parents or guardians in needed aspects of care/discharge planning. Ensures that educational needs with respect to schooling are met in an appropriate and timely manner. Familiar with the special needs of the school age patient and can access appropriate resources.
• ADOLESCENT: Knowledgeable of growth and development for age group and emotional, cognitive, educational, social and daily activity needs. Uses methods of communication appropriate to age group. Uses teaching techniques appropriate to age group. On assessment recognizes deviation from normal and integrates into the plan of care and/or discharge plan. Knowledgeable of case management interventions appropriate for age group. Involves patient in those care issues which he/she can make decisions. Parents or guardians involved in care decisions and education. Ensures that educational needs with respect to schooling are met in an appropriate and timely manner. Familiar with the special needs of the adolescent patient and can access appropriate resources.
• ADULTS: Knowledgeable of emotional, cognitive, educational, social and daily activity needs. Assesses level of understanding and ability to learn. Identifies ethical structure. Applies principles of adult learning when instructing adult patients. Includes patient in decision making and involves significant others as appropriate. Familiar with the special needs of the adult patient and can access appropriate resources.
• GERIATRICS: Knowledgeable of the aging process and emotional, cognitive, educational, social and daily activity needs. Able to assess the abilities and limitations of the patient. Demonstrates sensitivity to sensory/cognitive needs of the geriatric patient. Includes the patient in decision making and involves significant others as appropriate. Familiar with the special needs of the geriatric patient and can access appropriate resources.

Qualifications:

Experience:

Has two years of experience in the acute care setting, preferably in case management

Degrees, Licensure, and/or Certification:

Current RN licensure in the State of Arkansas

Obtains certification in Case Management within 3 years of hire date

BLS required

Knowledge, Skills, and Abilities:

Improves professional growth and knowledge of job to maintain efficiency and effectiveness of Case Management by any of the following means: belonging to professional organizations, attending approved seminars, subscribing to and reading journals and publications pertinent to case management activities.

Must be able to read, write, speak and understand English

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