Patient Care Navigator

1 week ago


Westerly Rhode Island, United States Yale New Haven Health Full time
Job Summary

Yale New Haven Health is seeking a skilled RN Case Manager to join our team. As a key member of our healthcare team, the RN Case Manager will be responsible for ensuring high-value patient care that is coordinated, efficient, and aligned with institutional clinical and financial objectives.

Key Responsibilities
  • Coordinate and ensure the implementation of the plan of care, utilizing the principles of case management.
  • Establish a system for coordinating the care of a patient throughout the continuum of care, linking inpatient care with outpatient care, services, and case management.
  • Optimize the efficiency of hospital systems which impact quality and/or length of stay.
  • Identify and monitor compliance with documenting variances from established parameters in the clinical pathway or treatment plan.
  • Ensure that each patient meets the clinical needs for admission, treatment, and discharge and initiates appropriate follow through with the health care team.
  • Assist clinicians in documenting the appropriateness of admissions and continued stays.
  • Responsible for Medicare notices of non-coverage and help provide appropriate documentation to appeal inappropriate denials.
  • Ensure that an appropriate discharge plan is developed and implemented with the health care team members to include identifying service, treatment, and funding options.
  • Link patient and family with the appropriate institutional or community resources, advocating on their behalf for scarce resources, and developing new resources where gaps exist in the service continuum.
  • Exhibit awareness of ethical/legal issues concerning patient care and strive to manage situations to reduce risk.
Requirements
  • Minimum of a Baccalaureate degree in a clinically related field.
  • RN licensure in Rhode Island required. Additional RN licensure in CT preferred.
  • Recent appropriate nursing experience, theoretical knowledge of the nursing process, case management and continuity of care.
  • Advanced communication and interpersonal skills with all levels of internal and external customers.
  • Ability to obtain and interpret information appropriate to patient needs and age.
  • Advanced assessment and teaching skills.
  • Leadership skills in planning and managing patient care as acquired through greater than 3 years of clinical nursing experience in an acute care hospital.
  • Utilization management and case management experience preferred.
  • Knowledge of computer software and hardware applications and a basic knowledge of statistics.


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