Registered Nurse - (RN) - Case Manager - FT - Days

Northeast Georgia Health System•Gainesville, GA

5d•Onsite

About The Position

Responsible for providing comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. Works collaboratively with Physicians, patient/family, nursing, utilization review, and other members of the healthcare team to assure patient management that efficiently and effectively aligns with patient needs using resources to meet quality, clinical, and cost-effective outcomes. Coordinates a team approach designed to facilitate the achievement of expected patient outcomes with appropriate transitions to the next level of care. Responsible for length of stay management, regulatory compliance, and attending/participating with interdisciplinary team rounds on assigned unit. Collaborates with community providers to facilitate and coordinate the plan of care for post-hospitalization needs of the patient. This position will come in contact with patients in the neonate, infant, child, adolescent, adult, and geriatric age groups. Employees will perform clinical duties in accordance with population specific guidelines and adhere to National Patient Safety Guidelines. Provides cross coverage for all RNCM as required across all settings in the care continuum, including weekend rotation (as needed).

Requirements

Licensed to practice as an RN in Georgia.
Associate degree.
Graduate of an accredited school of nursing.
Three (3) to five (5) years of experience in direct patient care and/or case management.
Financial and discharge planning experience.
Demonstrates aptitude in critical care, cardiac, medical, and/or surgical nursing
Working knowledge of State and Federal regulations required
Must demonstrate excellent observation skills, analytical thinking, problem solving abilities, and be self directed
Excellent oral and written communication skills
Demonstrates interpersonal skills including professionalism, a team player, pleasing personality and positive approach to the position
Demonstrates the ability to think outside of the box and consistently create new, and effective solutions to today's problems and opportunities.

Nice To Haves

CCM (Case Management Certification) or ACM (American Case Management Certification) preferred.
Bachelors Degree Preferred

Responsibilities

Monitor all patients on assigned units to ensure appropriate use of resources and interventions while managing patient's length of stay based on working DRG/admitting diagnosis.
Communicates with Physician, patient/family, and other disciplines the expected length of stay, along with patient progress towards discharge.
Provides coordination and facilitation oversight of patient care to ensure required interventions occur in proper sequence and processes occur in a timely manner without delays.
Identifies and acts upon potential delays in services; escalates unresolved delays to management for appropriate intervention.
Assesses, coordinates, and facilitates patient's discharge plan to ensure post-acute needs are arranged and secured prior to discharge; Communicates discharge plan with Physician, patient/family, and other members of the healthcare team as appropriate; Reassesses discharge plan routinely throughout patient's stay to ensure timely, safe discharge and appropriate transition to the next level of care.
Provides patient/family with information regarding their plan of care, discharge, and any financial responsibility of inpatient or post-hospitalization services.
Maintains knowledge of reimbursement methodologies and general coverage guidelines for all levels of inpatient and outpatient care.
Communicates with Physician, patient/family, or other team members as needed to ensure services will be covered.
Coordinates and communicates with Utilization Review Nurse on a daily, consistent basis to ensure patients are in the right status and level of care.
Facilitates changes by communicating with Physician, mid-level, or nursing staff as needed.
Serves as liaison to patients, family, Physicians, nursing staff, and all other disciplines to achieve optimal outcomes in the development of patient's discharge plan.
Serves as a leader on assigned unit in the areas of discharge planning, social service issues, community resources/referrals, and financial information related to patient care and outcomes.
Empowered to think outside of the box to consistently create new, and effective solutions to complex problems or opportunities.
Actively supports a customer service-oriented environment to continually enhance customer service; Communicates directly with Physicians, nursing staff, patient/family, and other disciplines to ensure collaborative practice.
Provides appropriate hand-off communication as patients transition from one unit to another to ensure and achieve optimal outcomes.
Maintains positive attitude, and communicates appropriately with patients/families, Physician, management, and other staff; responds positively to change and offers suggestions to effectively incorporate change as needed in daily workflow.
Maintains detailed knowledge of community resources, governmental regulations, third-party payers (PPO/HMO's) to facilitate appropriate outcomes.
Adheres to all regulatory and DNV requirements; Knowledgeable of third-party/governmental payer regulatory requirements and adheres to appropriate processes.
Completes paperwork as required.
Consistently demonstrates a 'sense of urgency' in his/her work, while mindful of the pillars and financial stewardship opportunities.
Works all scheduled shifts, including weekend rotation, and remote coverage.