Registered Nurse - Care Coordinator - 8 Hour Days

Cedars-Sinai•Los Angeles, CA

3d•$56 - $90

About The Position

The Case Manager Care Coordinator coordinates the care and services of patient populations from admission through discharge. The role clinically assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet individual health needs and facilitate a safe, timely discharge to the next appropriate level of care. Working collaboratively with interdisciplinary teams, the Care Coordinator develops comprehensive case management plans through effective care coordination and appropriate use of healthcare resources to achieve clinical and financial goals. The role partners with the healthcare team to address patients’ clinical, psychosocial, and financial needs in transition planning and manages timely progression of care and safe transitions.

Requirements

Associate degree or college diploma in Nursing (minimum).
At least 2 years of acute care nursing experience in Medical Surgical, Tele, ICU, or LTACH; or 1 year of acute care nursing experience in Medical Surgical, Tele, or ICU and 2 or more years of care management experience in utilization management or discharge planning.
RN State License upon hire.
Basic Life Support (BLS) upon hire.

Nice To Haves

Bachelor’s Degree in Nursing preferred.
Certified Case Manager; 2 years preferred. Experience and certification in case management preferred.

Responsibilities

Conduct in-depth case management assessments at admission and throughout the patient’s stay; obtain and confirm information needed to develop a comprehensive discharge or transition plan.
Review clinical findings and diagnostic reports, correlate medical record findings with patient assessments, and work with physicians on case management and transition plans.
Work with the Utilization Review Case Manager to monitor resource use and validate the appropriate level of care under Federal, State, and payer guidelines.
Collaborate with physicians, nurses, social workers, ancillary staff, and other healthcare team members, communicating assessment findings and transition recommendations to meet patient needs and achieve targeted outcomes.
Propose solutions to discharge barriers and identify and report physician-related barriers to the physician advisor.
Monitor length of stay, lead and facilitate Progression of Care Rounds, and proactively work toward expected length-of-stay and clinical targets.
Identify home care needs, including durable medical equipment and home infusion, early in hospitalization and complete timely referrals and arrangements.
Coordinate transfers to other acute care hospitals and referrals and discharges to Long Term Acute Care Hospitals and Skilled Nursing Facilities.
Maintain knowledge of payer and reimbursement rules related to care coordination and discharge and transition planning.
Collaborate with Case Management Assistants and Social Workers to ensure Important Message from Medicare letters are delivered within the specified timeframe.
Address system-level issues impeding diagnostic or treatment progress, escalate unresolved improvement opportunities, identify and resolve discharge barriers, and document avoidable-day information in CS Link.
Promote understanding and use of Advance Directives and POLST, and ensure patients’ end-of-life wishes are understood and respected.
Identify the primary patient or family decision maker and communicate care plans, transition plans, and expected outcomes.
Maintain knowledge of Federal, State, and other regulatory requirements, including The Joint Commission and CMS rules concerning Observation status, the 2 Midnight Rule, and Medicare Inpatient Only Procedures.