Montana RN Care Manager Position
7 days ago
About The Staff Pad: We are a non-profit healthcare system based in Helena, Montana committed to delivering superior care with a hometown commitment.
Estimated Salary Range: $ 120000 - 150000 per year, depending on experience and qualifications.
Job Description:
The RN Care Manager is responsible for facilitating the patient's progress through the Emergency Room and acute episode of care in an efficient and cost-effective manner. This includes ensuring the level of care from the ED through discharge, initiating evidence-based protocols and order sets according to the patient's admission diagnosis, influencing the progression of care, and proposing an appropriate transition plan within 24 hours of admission.
Duties and Responsibilities:
• Collaborate with medical staff to assure correct admission status and confirm treatment goals, treatment plan, and clinical mileposts used to advance the treatment plan.
• Meet with patient and family, observe clinical status, and communicate with the patient's healthcare team to assess and document the patient's navigation and transition needs.
• Coordinate patient information to assure timely reviews according to UR work plan and follow-up with E.H.R. physician consultants.
• Identify potential financial barriers to the progression of care and make referrals to a Social Worker Counselor or financial counselor, or other services as needed to swiftly resolve.
• Using pre-determined high-risk screens to identify selected patients with potential transition challenges and assigns to the Social Worker Counselor for focused management.
• Confirm admission diagnosis and correct admission status and identifies related quality measures to promote medical compliance.
• Progression of Care: Collaborate with admitting physician, ED physicians, Hospitalists, Documentation Specialist, and other ancillary staff to assist with the initial patient assessment and high risk screen for the purpose of resource management.
• Promote adherence to clinical protocols through collaboration with the physician and interdisciplinary team to encourage evidence-based interventions relevant to the patient's reason for admission and immediate acute care needs.
• Provide point-of-care coaching to the medical staff for documentation improvement and observance of safety and quality indicators to support admission status and care plan.
• Accompany physicians and Hospitalists on patient rounds based on patient priorities and suggests treatment alternatives to reduce discretionary resource consumption and reduce excessive length of stay.
• Initiates referrals in collaboration with nursing staff for home health, hospice, DME, rehab, etc. and aligns the needs of patients with placement options that are consistent with the desired quality target and patient's financial resources.
• Consults with the Medical Advisor as necessary to resolve barriers through appropriate administrative and medical channels.
• Demonstrates pro-active communication to influence treatment plan and progression of care while advocating on behalf of the patient and organizational stakeholders.
• Attends daily Hospitalist/staffing meetings and promotes CM/UR RN role as an adjunct to the team's clinical expertise.
• Transition/Discharge: Identifies patient/families with complex psychosocial or continuing care needs that may present obstacles for a safe transition to a lower level of care or discharge to the community and makes a referral to the Social Worker Counselor.
• Works in tandem with Social Worker Counselor to monitor the progress of completing complex discharge plans and collaborates to resolve challenges.
• Facilitates patient movement to alternate levels of care within the hospital through collaboration with patient/family, physician, and interdisciplinary team and takes responsibility for moving patients to Swing Bed status as appropriate.
• Responsible for assuring that Swing Bed documentation is initiated and completed as per regulatory requirements.
• If CM/UR RN is not able to follow patient through entire episode of care, directly communicates patient plan of care, progression of care barriers, and probable transition needs to receiving case manager to follow, on a daily basis.
Qualifications:
KNOWLEDGE/EXPERIENCE: Minimum of 3-5 years of acute care experience.
EDUCATION: Clinical preparation. Registered Nurse Required. Baccalaureate degree or equivalent experience preferred.
LICENSE/CERTIFICATION/REGISTRY: Licensure in the State of Montana. Certification in Case Management and/or Utilization Review desired.
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