Nurse Case Manager

3 days ago

Chicago, Illinois, United States Managed Care Staffers Full time
Job Summary

The RN Case Manager will coordinate service with patient care units such as the interdisciplinary team including, but not limited to, Dental, Nutrition, Behavioral Health, WIC, Healthy Start and any other programs providing care services.

As part of the interdisciplinary team, the clinical nurse establishes goals and strategies for meeting care coordination needs across settings with the patient, family, and/or other care providers. Also considers factors related to safety, effectiveness and fiscal accountability in planning and delivering care.

Key Responsibilities
  • Initiates the development of a care plan for each patient, which includes performing a risk assessment and assigning risk to 100% of caseload on assigned panel.
  • Engages the interdisciplinary care team (MA, PFC, PSR, Provider, MFM, Referral) to manage quality care and services.
  • Promotes referrals to support services to include, but not limited to, Dental, Nutrition, Behavioral Health, WIC, Healthy Start, and any program providing care services.
  • Tracks appointments and monitors no shows or non-compliance to re-establish patients for continuity of care.
  • Oversees care for management of multiple disease processes for diagnosed patients.
  • Provides follow up on abnormal labs, communicates treatment plans, per provider order, and provides appropriate patient education.
  • Liaisons with Labor and Delivery departments at affiliated hospitals or referral institutions for continuity of care and discharge planning.
  • Prepares patients for delivery at assigned hospitals by assisting to set up hospital tours and establishing pre-birth visits.
  • Provides post-delivery services to include newborn support, family planning options, and appropriate inter-conceptual spacing education.
  • Actively prepares for and participates in weekly rounds with CMO and peers for case discussions as well as the Womens Health monthly meeting.
  • Maintains frequent contact with patients during all trimesters and post-delivery to ensure compliance with plans of care.
  • Documents in EHR all patient communications and services from entry into care through 12 weeks post-partum.
  • Follows outcomes of all high-risk patients, including transfers to tertiary centers through delivery and 12 weeks post-partum, to include newborn care and support.

Requirements include a minimum of a bachelors degree in Nursing, a valid license in the state of IL, and a minimum of two (2) to five (5) years of acute nursing experience. Previous experience in case management of obstetrical patients is highly desirable.

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