Case Management Nurse
2 weeks ago
Overview
TriStar Skyline Medical Center is seeking a skilled Case Management RN to join our healthcare team. As a Case Management RN, you will play a vital role in promoting patient-centered care by coordinating the plan of care for patients, managing length of stay, and ensuring appropriate resource management.
Responsibilities
- Provide case management services for inpatient and observation patients, identifying those at risk for adverse outcomes during transition from one level of care/setting to another.
- Perform comprehensive assessments of psychosocial, medical, and discharge needs of patients/family, along with an assessment of resources available to the patient/family.
- Reassess patient's clinical condition as indicated, considering readmission status or risk of readmission and developing strategies to mitigate.
- Coordinate plan of care and drive discharge plan by collaborating with multidisciplinary healthcare team and patient's physician to facilitate successful care transition.
- Partner with Social Services to ensure post-acute medical needs and level of care are appropriate.
- Assume responsibility for timely referral to Social Services when risk factors for psychosocial determinants of health are identified.
- Involves patient and family/responsible/significant others in identifying and clarifying needs and expectations to develop mutual and realistic goals.
- Evaluates progression of care using evidence-based tools and approved criteria throughout episode of care; escalates progression and transition of care issues through established chain of command.
- Makes appropriate referrals to third-party payer and disease and case management programs for recurring patients and patients with chronic disease states.
- Facilitates patient throughput with ongoing focus on effective care transition, quality, and efficiency.
- Documents professional recommendations, discharge plan, care coordination interventions, and case management activities to effectively communicate to all members of healthcare team.
- Aligns patient needs with available resources to ensure safe discharge/transition.
- Acts as liaison through effective and professional communications between and with physicians, patient/family, hospital staff, and outside agencies.
- Actively seeks ways to control costs without compromising patient safety, quality of care, or services delivered.
- Directs activities to identify and provide for needs of under-resourced patient population, including patient education activities, patient assistance programs, and community-based resources.
- Participates in performance improvement activities, including identifying, documenting, and intervening when avoidable days occur.
- Adheres to established policy and procedure and standards of care; escalates issues promptly through established chain of command.
Requirements
- Current Registered Nurse license in Tennessee or appropriate compact state.
- Appropriate communication skills.
TriStar Skyline Medical Center is a 250+ bed facility, offering a comprehensive stroke center and national leader in neuroscience. We are equipped with 3 helipads, new ICU and Medical/Surgical floors, and burn care services. We offer a CARF accredited Inpatient Rehabilitation program and are an ACS verified Level II Trauma Center. As an Accredited Chest Pain Center with PCI, TriStar Skyline is a leading provider of emergency heart care.
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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