Case Manager RN

4 weeks ago

Alma Michigan, United States MyMichigan Health Full time
Summary:
The Case Manager performs a variety of integrated functions while applying broad professional nursing knowledge.  Analyzes and evaluates medical information for quality and appropriateness of care; screens records with variations for peer review; responsible for appropriate and timely intervention and coordination with other members of the Care Management Team to resolve problems related to quality/utilization management activities; provides pertinent clinical data to outside agencies as needed to assure compliance with their requirements; acts as a resource for hospital and medical staff regarding clinical documentation requirements; evaluates patient outcomes through clinical path monitoring. 

Responsibilities:
(25%)* Documents appropriate to patients needs and documentation requirements.

 

(25%)* Collaborates with staff, patients, and families in coordinating the referral of patients to appropriate community agencies as determined by their individual discharge plan.

 

(25%)* Initiates timely discharge planning screening on all admissions, and assesses further as needed.

 

(25%)* Develops a discharge plan based on needs identified from assessment.

OTHER DUTIES AND RESPONSIBILITIES:

Operates department within volume adjusted budget.

 

Demonstrates ability to communicate effectively with the medical staff to achieve desired outcomes.

 

Promotes opportunities for staff education in:

New employee orientation

Department/job specific education

 

Education for new services provided by the department.

 

Sets yearly departmental and personnel goals.

 

Assist in education of staff on Case Management policies, procedures, and community resources.

 

Assumes responsibility for continuing education/professional development related to area of practice; including job specific professional journals.

 

Maintains effective quality management and/or improvement program to measure assess and prove services of the department.

 

Markets MyMichigan Medical Center- Gratiot and their subsidiaries, using their services when appropriate to patient/needs/desires.

 

Maintain relationships with community agencies to keep current with available resources.

Facilitates multidisciplinary team meetings as scheduled.

 

Implements discharge plan and monitors need for changes in plan to avoid delays in discharge in collaboration with other team members.

 

Provides direction with implementation of care pathways.

 

Responsible for concurrent review of charts to ensure compliance with core measures and other quality measures as determined.

 

As a member of the Utilization Management team, strives to develop and assist with effective utilization management processes.

 

Demonstrates competency in Infection Prevention and Control Practices and Policies.

 

RM CM may be responsible for Utilization Review and Discharge Planning simultaneously or separately based on department and health system needs. Additional cross training will be available when required and requested.

 

 

 

Other Duties as assigned.

Certifications and Licensures:
Registered Nurse license required

 

Required Education:
Associate's Degree in Nursing required

Equivalent Experience: Three to five years of recent clinical experience in the acute care setting is required. Knowledge of data analysis and bachelors of Science preferred or a commitment to pursue such degree is preferred.

 

 

 

Other Information:
EXPERIENCE, TRAINING AND SKILLS:

Three to five years of recent clinical experience in the acute care setting.

 

Must be proficient with computer skills and applications. 

 

Interpersonal skills needed to communicate successfully with individuals and groups and interact with people at all levels to communicate ideas and concepts in a clear and understandable manner.

 

Mandatory tuberculosis (TB) testing must be done as required.

 

Mandatory Occupational Safety and Health Administration (OSHA) training must also be completed annually according to the Exposure Control Plan.

 

PHYSICAL/MENTAL REQUIREMENTS AND TYPICAL WORKING CONDITIONS:

Exposure to stressful situations, including those involving public contact, as well as, trauma, grief and death.

 

Able to wear personal protective equipment that includes latex materials or appropriate substitute if required for your position.

 

Is able to move freely about facility with or without an assisted device and must be able to perform the functions of the job as outlined in the job description.

 

Overall vision and hearing is necessary with or without assisted device(s).

 

Frequently required to sit/stand/walk for long periods of time. May require frequent postural changes such as stooping, kneeling or crouching.

 

Some exposure to blood borne pathogens and other potentially infectious material.  Must follow MyMichigan Health bloodborne pathogen and TB testing as required.

 

Ability to handle multiple tasks, get along with others, work independently, regular and predictable attendance and ability to stay awake.

 

Overall dexterity is required including handling, reaching, grasping, fingering and feeling.  May require repetition of these movements on a regular to frequent basis.

 

Physical Demand Level: Sedentary.  Must be able to occasionally (0-33% of the workday) lift or carry 0-10 lbs.

Other Comments:
 

 

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