RN Case Manager
4 weeks ago
We are seeking a skilled RN Case Manager to join our team at PeaceHealth. As a RN Case Manager, you will be responsible for coordinating and monitoring patient care, including daily plans and stay plans. You will perform patient care review activities, such as monitoring and correcting patient status, documentation for medical necessity of admission and continued hospitalization, and concurrent review.
Key Responsibilities- Provide initial and ongoing assessments of patients' needs for services in collaboration with the healthcare team.
- Monitor and evaluate utilization of services to focus on the best treatment and approach for the patient, promoting timely progression of interventions, utilization of resources, and expected outcomes within a length of stay consistent with external regulations and standards.
- Provide utilization management, including facilitating appropriate status assignment per Medicare and InterQual criteria, ensuring appropriate documentation for medical necessity of admission and continued hospitalization, and ensuring appropriate level of care bed assignment.
- Implement opportunities to improve effectiveness in utilization.
- Provide transition planning coordination, including identifying needs and implementing referrals to other clinical care providers, evaluating patient progress, and revising the care plan as needed.
- Act as a resource for physician offices, physicians, and staff regarding Intensity Severity Discharge (ISD) criteria, identifying barriers to achieving patients' discharge, and assisting the care team in overcoming them.
- Provide patient/family education to facilitate an understanding of their hospital and post-hospital course, their status assignment, and discharge appeal rights, and provide advocacy for their care.
- Effectively communicate and provide clear and concise documentation according to department standards and regulatory requirements.
- Refer to appropriate internal and community resources as necessary.
- Accredited School of Nursing Required
- Minimum of 3 years RN experience in a hospital setting with medical/surgical experience and supervisory/preceptor experience
- 1 year Preferred: Surgical patient population experience
- WA State Registered Nurse License Required
- Basic Life Support Certification Required Upon Hire
- Certified Case Manager Preferred Upon Hire
PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package, including full medical/dental/vision coverage, 403b retirement plan employer base and matching contributions, paid time off, employer-paid life and disability insurance with additional buyup coverage options, tuition and continuing education reimbursement, wellness benefits, and expanded EAP and mental health program.
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