Registered Nurse Case Manager -- Resource Center for Case Mgmt -- General Hospital

Job Summary

Collaborate with and serve as an expert resource to the health care team to enhance the delivery of patient care services. Efficiently coordinate patient needs to assure high quality patient care, reduce length of stay and resource utilization and ensure reimbursement drawing on a broad clinical and systems management knowledge base.

Responsibilities

• Intervenes with physicians and ancillary departments concerning clinical and utilization issues to ensure optimal patient outcomes.

• Identify tests, procedures and interventions earlier to advance the plan of care.

• Provides real time interventions to prevent delays and ensure compliance and revenue integrity with health care regulations.

• Evaluates complex patients for needs and barriers to discharge and potential re-admissions.

• Assist with transfers to other facilities.

• Provides code 44 documents to Medicare patients when applicable.

• Acts as a resource to assist others with patient care management.

• Ensures patient rights are sustained and safeguard patient privacy and confidentiality.

• Assists social worker with medication prior authorizations when necessary.

• Monitors trends and report practice issues of the multidiscipline health care team that impacts finances and quality care issues. Implement appropriate measures to resolve issues.

• Directs attending and consulting physicians, residents, staff nurses and other members of the multidisciplinary team to address system processes that impact the timely delivery of care.

• Identifies educational needs of the staff and physicians and provide continuing education.

• Participates in hospital/unit committees as requested.

Knowledge, Skills & Abilities

Patient Group Knowledge (Only applies to positions with direct patient contact)

The employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department’s identified patient ages. Specifically the employee must be able to demonstrate competency in: 1) ability to obtain and interpret information in terms of patient needs; 2) knowledge of growth and development; and 3) understanding of the range of treatment needed by the patients.

Competency Statement

Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist.

Common Duties and Responsibilities
(Essential duties common to all positions)

1. Maintain and document all applicable required education.
2. Demonstrate positive customer service and co-worker relations.
3. Comply with the company's attendance policy.
4. Participate in the continuous, quality improvement activities of the department and institution.
5. Perform work in a cost effective manner.
6. Perform work in accordance with all departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations.
7. Perform work in alignment with the overall mission and strategic plan of the organization.
8. Follow organizational and departmental policies and procedures, as applicable.
9. Perform related duties as assigned.

Education

• Bachelor's Degree (Required) Education: Or related degree Experience: 7 years -Clinical Experience Pertinent to Position Substitution: Associates Degree and 9 Years Relevant Experience May be Substituted for Bachelors degree and 7 years experience.

Credentials

• Registered Nurse (Required)

Work Schedule: Days

Status: Full Time Regular 1.0

Location: General Hospital

Location of Job: US:WV:Charleston

Talent Acquisition Specialist: Lauren R. Lane lauren.lane@vandaliahealth.org