RN, Case Manager, Hospital Care Coordinator
6 days ago
About the Role:
We are seeking a skilled RN Case Manager to join our team at UofL Health. As a key member of our Care Coordination Department, you will play a vital role in promoting optimal management of clinical resources and ensuring the quality and appropriateness of patient care.
Responsibilities:
- Promote optimal management of clinical resources by conducting timely initial admission assessments based on clinical indicators and anticipated service needs for appropriate level of hospital care;
- Validate patient demographics and payor source;
- Utilize and contribute to the development of the multidisciplinary clinical assessment of patients on an on-going basis during the patient's admission to ensure the quality and appropriateness of patient care;
- Implement, reassess, and evaluate patient condition and coordinates plan of care daily;
- Develop patient specific plan of care based on the individual needs of the patients, conversations with providers and other staff, and documentation in electronic medical record (EMR);
- Ensure updated plan of care is documented in the EMR;
- Coordinate the discharge needs of patients with necessary internal and external providers while protecting patient information;
- Perform timely, professional, and appropriate documentation as reflected in the Quality Review Audit process;
- Advocate for patient/family needs in a respectful, non-judgmental, and confidential manner;
- Serve as a liaison or facilitator for the patient and interdisciplinary healthcare team in the management of unusual or questions cases;
- Educate the healthcare team about the role of the RN: Case Manager;
- Is accessible to the healthcare team as a resource;
- Appropriately refers cases to manager/director of care coordination, CAO, or medical director when intensity of service or severity of illness is not present and is unable to be resolved;
- Ensure delivery of Discharge Medicare Important Message (IM) and Medicare Outpatient Observation Notice (MOON), where applicable;
- Acknowledge, address, and complete are Consults to Case Management on respective units in EMR;
- Works collaboratively with social workers to identify social and financial barriers and community resources;
- Completes referrals to Social Worker for patients with high-risk indicators;
- Attends monthly departmental staff communications meetings. Serves as an active member of committees, as needed, which may include a variety of projects or topics;
- Enhances professional growth and development through participation in educational programs, reading current literature, attending in-service meetings and workshops that are related to assigned areas of responsibility;
- Assumes responsibility of growth and development, maintains competency in care management principles;
- Educates physicians, patients, and staff with regards to payors, financial issues, documentation, and potential compliance issues;
- Serves as a resource to physicians for clinical management and financial issues;
- Assists the providers with promoting efficiencies in the care delivery system and reducing/ eliminating barriers to efficient/effective service;
- Maintains compliance with all company policies, procedures and standards of conduct;
- Complies with HIPAA privacy and security requirements to maintain confidentiality at all times;
- Performs other duties as assigned;
Qualifications:
- Licensed or eligible for license in Kentucky;
- Basic Life Support (BLS) accredited by the American Heart Association (AHA);
- Bachelor's degree from accredited college or University or RN with a Bachelors Degree in Business or Health Care Administration preferred;
- Must have 5+ years of care management experience in an acute hospital setting;
- Must be able to adjust priorities quickly, organize multiple tasks simultaneously, and work interdependently with many levels of staff;
- Attention to detail; strong organizational, interpersonal and communication skills; and innovative problem solving skills required;
- Must be able to adjust work hours depending on depending upon departmental needs as determined by the director or manager;
- Certification in a nursing specialty area or CCM preferred;
Benefits:
- Competitive Pay & Benefits Options;
- Paid Vacation, Sick days, and Holidays;
- Free tuition to UofL for Part- and Full-time employees for Child/Spouse/Domestic Partner;
- 401K with Employer Match;
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