Healthcare Specialist

3 days ago

SaintAubinsurGaillon, Normandie, United States Grace Federal Solutions,Llc Full time
About Us
At Grace Federal Solutions, we prioritize our employees' significant roles in helping us grow and transform the company. Our five core principles - client service, purpose, mutual respect, collaboration, and accountability - guide our mission to build a top-notch healthcare services company with comprehensive support services.

We seek talented professionals who can thrive in an environment that values innovation and teamwork. If you're passionate about making a difference in people's lives, let's connect

Job Summary
This role involves providing ongoing expertise through comprehensive assessment, planning, and evaluation of individual patient needs. The goal is to enhance patient management quality, promote continuity of care, and ensure cost-effectiveness by integrating case management, utilization review, and discharge planning functions.

Key Responsibilities
  • Identify high-priority cases and review work lists daily to prioritize patients and identify new admissions.
  • Conduct assessments and document plans of care in Epic per departmental guidelines.
  • Participate in daily care management touchpoints according to established protocols.
  • Consult social workers per established criteria.
  • If necessary, communicate priorities with Care Management Assistants.
  • Attend CAPP meetings for assigned units to provide and receive information on patients' progress.
  • Alert care teams to concerns impacting anticipated discharge dates or readiness.
  • Modify discharge plans based on meeting information.
  • Assist in identifying expected discharge dates.
  • Complete follow-ups from CAPP as needed.
  • Meet with Utilization Managers and Social Workers after meetings to discuss updates and action items.
  • Attend weekly Complex Care Meetings (CCMs) to present on patients, collaborate on problem-solving complex cases, and identify trends.
  • Formulate potential solutions with Utilization Managers and Social Workers, continuously monitoring cases and following up on action items.
  • Proactively identify high-risk cases that need escalation to the list not scheduled for discussion that week.
  • Complete CCM follow-ups after meetings as assigned.
  • Discuss barriers to discharge and psychosocial concerns impacting progression of care or readmission risk with multidisciplinary teams.
  • C coordinate family meetings, when necessary, to support progression of care.
  • Provide education on community resources, support groups, and other relevant resources to patients, families, and care teams.
  • Educate and/or coordinate referrals to community resources and post-acute providers as necessary.
  • Communicate medical milestones for transitions with patients and families.
  • Monitor observation patients throughout the day to ensure appropriate progression of care.
  • Identify patients' readiness for discharge based on discussions with patients, families, and care teams on an ongoing basis.
  • Assess discharge plans to determine needs post-discharge and communicate to patients, families, and care teams on an ongoing basis.
  • Identify required authorizations for post-discharge services and refer to appropriate providers.
  • Participate in medication resource management for non-resourced patients, as needed.
  • Verify patients' understanding and agreement with discharge plans.
  • Refer administrative tasks to Care Management Assistants.
Requirements
Estimated salary: $80,000-$120,000 annually.
The ideal candidate should have two years of experience in healthcare as a Registered Nurse, with strong assessment and critical thinking skills. A nursing diploma or ADN/ASN from an accredited school of nursing is also required. Preferred qualifications include a BSN or MSN from an accredited school of nursing and licensure to practice as a Registered Nurse in North Carolina.

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