Care Management Nurse

Good Samaritan•Vincennes, IN

3d•Onsite

About The Position

The Care Management Nurse is responsible for the delivery of the Care Management Plan. This involves assessing each patient's needs and formulating a plan of action through interaction with the patient/family, physicians, coworkers, and outside agencies. The nurse will coordinate care throughout the continuum from admission through post-hospitalization, ensuring that care rendered is appropriate, timely, high quality, cost-effective, and complies with the Mission Statement. The role also ensures that the patient is placed at the appropriate level of care to meet criteria for Medicare, VA, self-pay, and Humana Medicare. The nurse demonstrates knowledge of Federal and State regulations regarding healthcare delivery, including liability issues. Additionally, the Care Management Nurse assists managers, physicians, and direct patient care staff to identify and resolve "system" issues and actively participates in daily interdisciplinary rounds with members of the care team to develop comprehensive case management plans. Communication with the patient and family to determine their specific needs and expectations is also a key responsibility. The nurse is expected to apply for the nursing council or committee and be vested in one council at least every 5 years, with 80% attendance required. Advancements in the Clinical Ladder are reflected in the yearly application process and are expected for job performance standards. Secondary duties may include monitoring inpatient records for adequate documentation, setting, and timeliness of treatments as ordered.

Requirements

Possesses excellent verbal and written skills, and ability to problem-solve.

Nice To Haves

Advancements in Clinical Ladder will be reflected in yearly application process and is expected for job performance standards.

Responsibilities

Responsible for delivery of the Care Management Plan.
Assess each patient’s needs and formulate a plan of action using interaction with patient/family, physicians, coworkers, and outside agencies in order to formulate a comprehensive plan.
Coordinate care throughout the continuum from admission through post-hospitalization.
Ensure that care rendered is appropriate, timely, high quality, cost-effective, and complies with our Mission Statement.
Ensure that the patient is placed at a level of care to meet criteria of Medicare, VA, self pay and Humana Medicare.
Demonstrates knowledge of Federal and State regulations regarding health care delivery, including liability issues.
Assists managers, physicians and direct patient care staff to identify and resolve "system" issues.
Actively participates in daily interdisciplinary rounds with members of the care team, such as social workers, nursing, physical therapists, dietitians or others as needed, in order to develop a comprehensive case management plan for each patient.
Communicates with the patient and family to determine their specific needs and expectations.
Apply for nursing council or committee and be vested on one council at least every 5 years. 80% attendance in person or by phone is required.
Monitors inpatient records to ensure adequate documentation, setting and timeliness of treatments as ordered.
Performs any other duties as assigned by the Care Management Coordinator or Care Management Committee.