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

Northeast Georgia Health System•Braselton, GA

1d•Onsite

About The Position

Responsible for providing comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. Works collaboratively with physicians, patients/families, nursing staff, utilization review, and other members of the healthcare team to ensure patient management aligns with quality, clinical, and cost-effective outcomes. Coordinates a team approach to facilitate expected patient outcomes and appropriate transitions to the next level of care. Responsible for length of stay management, regulatory compliance, and participating in interdisciplinary team rounds. Collaborates with community providers to coordinate the plan of care for post-hospitalization needs. This position interacts with patients across all age groups (neonate to geriatric) and performs clinical duties in accordance with population-specific guidelines and National Patient Safety Guidelines. Provides cross-coverage for all RN Case Managers 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

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.
Communicate with Physician, patient/family, and other disciplines the expected length of stay, along with patient progress towards discharge.
Provide coordination and facilitation oversight of patient care to assure required interventions occur in proper sequence and processes occur in a timely manner without delays. Identify and act upon potential delays in services; escalate unresolved delays to management for appropriate intervention.
Assess, coordinate and facilitate patient's discharge plan to assure post-acute needs are arranged and secured prior to discharge; Communicate discharge plan with Physician, patient/family, and other members of the healthcare team as appropriate; Reassess discharge plan routinely throughout patient's stay to ensure timely, safe discharge and appropriate transition to the next level of care. Provide patient/family with information regarding their plan of care, discharge and any financial responsibility of inpatient or post-hospitalization services.
Maintain knowledge of reimbursement methodologies and general coverage guidelines for all levels of inpatient and outpatient care. Communicate with Physician, patient/family or other team members as needed to ensure services will be covered.
Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure patients are in the right status and level of care. Facilitate changes by communicating with Physician, mid-level or nursing staff as needed.
Serve as liaison to patients family, Physicians, nursing staff and all other disciplines to achieve optimal outcomes in the development of patient's discharge plan. Serve 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 support a customer service oriented environment to continually enhance customer service; Communicate directly with Physicians, nursing staff, patient/family and other disciplines to ensure collaborative practice. Provide appropriate hand-off communication as patients transition from one unit to another to ensure and achieve optimal outcomes.
Maintain positive attitude, and communicate appropriately with patients/families, Physician, management and other staff; respond positively to change and offer suggestions to effectively incorporate change as needed in daily workflow.
Maintain detailed knowledge of community resources, governmental regulations, third party payers (PPO/HMO's) to facilitate appropriate outcomes.
Adhere to all regulatory and DNV requirements; Knowledgeable of third party/governmental payer regulatory requirements and adhere to appropriate processes. Complete paperwork as required.
Consistently demonstrate a 'sense of urgency' in his/her work, while mindful of the pillars and financial stewardship opportunities.
Work all scheduled shifts, including weekend rotation, and remote coverage.