Case Manager Emergency Department- Case Management

Legacy Health • Gresham, OR

21h

About The Position

The Case Manager in the Emergency Department coordinates and facilitates interdisciplinary, comprehensive, patient-centered, quality care for patients with acute and chronic health conditions throughout the continuum of care. The role supports optimal health outcomes within accepted standards of care and serves as an expert resource to the healthcare team on care transitions, resource use, best-practice protocols, team-based care, quality improvement, and regulatory requirements.

The Case Manager plans smooth transitions between healthcare environments, partnering with patients and families to identify care needs and barriers to self-care, set priorities, and choose appropriate interventions. The role uses culturally agile, health-literacy-informed education to support self-management, monitors and reports intervention outcomes through rapid quality-improvement cycles, and coordinates care across the continuum in an appropriate and fiscally sound manner.

Requirements

• Minimum of 2 years of clinical nursing experience.
• Extensive knowledge of disease management, including diagnostics, treatment, prognosis, community resources, and healthcare reimbursement.
• Knowledge of levels of care across the healthcare continuum, including inpatient, emergency care, rehabilitation, home health, hospice, long-term acute care, SNF, ICF, and ALF, and an overall understanding of utilization and resource management.
• Working knowledge of care-management models across the continuum.
• Knowledge of the six core components of case management: psychosocial aspects, healthcare reimbursement, rehabilitation, healthcare management and delivery, and principles of practice including CMS guidelines and InterQual criteria.
• Knowledge of case-management concepts.
• Excellent organizational skills.
• Health-literate oral and written communication skills for effective interaction with all members of the patient's healthcare team.
• Knowledge of transitional planning to and from all care venues.
• Ability to determine and access appropriate community resources.
• Ability to engage patients and families in discussions of healthcare goals and decisions while considering cultural and health-literacy implications.
• Ability to adhere to and implement regulations effectively.
• Keyboard skills and ability to navigate electronic systems applicable to job functions.
• Current applicable state RN licensure.
• BLS for Healthcare Providers from the American Heart Association is required for employees performing this job in Oregon.

Nice To Haves

• Academic degree in nursing (BSN or higher) preferred.
• Relevant experience in coordination of community resources, care management of diverse patient populations, or ambulatory care preferred.
• Case management certification preferred.

Responsibilities

• Coordinate and facilitate interdisciplinary, comprehensive, patient-centered care throughout the continuum for patients with acute and chronic health conditions.
• Support optimal healthcare outcomes within accepted standards of care.
• Serve as an expert resource to the healthcare team on the continuum of care, efficient resource use, best-practice protocols, team-based care, quality indicators and improvement, and regulatory requirements.
• Ensure smooth care transitions between healthcare environments using planned handoffs.
• Partner with patients and families to identify healthcare issues and barriers to self-care, establish priorities, and engage appropriate interventions.
• Use cultural agility and health-literacy guidelines to provide education on self-management strategies.
• Use rapid quality-improvement cycles to monitor, evaluate, measure, and report intervention progress and outcomes.
• Coordinate cases to support appropriate and fiscally sound care across the continuum.
• Serve as a resource to team members regarding regulatory issues and implement applicable regulations effectively.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed