RN Care Transition Specialist

2 weeks ago

Edina, United States Fairview Health Services Full time

Overview M Health Fairview Health Services is searching for a hardworking and enthusiastic RN who is looking for an exciting career in our busy Care Management Department located at our Edina, Minnesota campus Fairview Southdale Hospital offers care to people living and working in the southwest Twin Cities metro area. With more than 40 specialty services, we combine talents to balance innovative technologies and treatments with the art of medicine. Working together, we respectfully address the comprehensive needs of our patients and their families. About this unit: This Care Transitions Specialist-RN provides comprehensive care coordination of patients as assigned. The care coordinator 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. This position is 64 hours per pay period, days, 8 hour shifts with one weekend per month. We offer generous benefits including medical, dental, time off and more. Check out additional benefits information here: www.fairview.org/benefits/TCMNARN Responsibilities Job Description The Registered Nurse is responsible for the assessment, planning, delivery, and evaluation of nursing care for all assigned patient population(s). The RN is responsible for performing these responsibilities in accordance with all policy, procedures, professional practice guidelines and the MN Nurse Practice Act. The RN coordinates care with members of the health care team and delegates responsibilities to others as appropriate. 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 Qualifications Required MN RN License BLS for Health Care Providers Three to five years of current RN acute care clinical experience Preferred Experience 1+ years working as a care coordinator/case manager Bachelor’s Degree in Nursing EEO Statement EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status

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