Registered Nurse, Non-Certified Case Manager

Claiborne Medical Center • Tazewell, TN

287d

About The Position

The RN Case Manager (Non-Certified) is a member of a multidisciplinary team and is responsible for integrating expert clinical practice into the patient care setting, coordinating education of staff and patients and serving as a clinical resource and consultant to the health care team. The RN Case Manager (Non-Certified) is responsible for promoting patient care continuity and quality through the collaborative development of practice guidelines and clinical pathways that support quality improvement activities. The RN Case Manager (Non-Certified) actively seeks opportunities in research designed to identify best practices. The RN Case Manager (Non-Certified) has the responsibility, accountability and authority for providing comprehensive care coordination and knowledge to assess, plan, implement, coordinate, monitor and evaluate options, services, and outcomes to meet the patient's health care and human service needs by promoting quality and cost effective intervention for the designated patient population. Activities and interventions include maintaining patient's privacy, confidentiality, safety, advocacy, adherence to ethical, legal, and accreditation/regulatory standards.

Requirements

• Two (2) years of acute care nursing experience.
• Two (2) years of experience in assigned area of responsibility.
• Must have and maintain Tennessee RN License.

Responsibilities

• Utilizes case finding criteria to screen patients and gather information from the medical record, physician documentation and communication, patient/family as well as other sources to develop a comprehensive plan for the patient that will meet identified needs.
• Utilizes the nursing process to assess and periodically reassess the patient's progress towards established goals.
• Modifies the case management plan to meet the changing needs of the patient's clinical condition.
• Secures needed resources via a multidisciplinary approach to case management strategy to assure timely, efficient and cost effective services.
• Designs and implements practice guidelines and clinical care designs in collaboration with physicians and other members of the health care team for assigned population.
• Identifies specific objectives, goals, and actions to meet the patient's identified needs.
• Collaborates and communicates effectively with the physician and other members of the health care team to plan and implement the care of the patient in a timely manner.
• Documents communication results and direction in the patient's medical record.
• Communicates effectively with physician offices, home health agencies, rehabilitation facilities, long term care facilities, and third party payers to identify goals to assure that patients receive the most appropriate, cost effective and efficient means of care.
• Executes and documents the Case Management activities and interventions related to specific patient goals.
• Serves as liaison to provide communication with the patient/family, physician and the health care team.
• Coordinates, organizes, secures, integrates, modifies and documents resources needed to accomplish goals related to the Case Management discharge plan.
• Serves as the 'brokering' agent as patient advocate to secure coverage for needed community services.
• Gathers sufficient information from all relevant sources and documentation regarding the case management plan and activities and or services to enable the Case Manager to determine the plan's effectiveness.
• Mobilizes resources and coordinates the effort of the health care team to achieve a positive patient transition to appropriate next level of care.
• Identifies and communicates variances in the patient's process of care to the appropriate member(s) of the health care team.
• Conducts Discharge Planning Rounds to determine and document the Case Management plan's effectiveness in obtaining the desired outcomes and goals.
• Evaluates the Case Management plan and modifies or changes the plan as needed to meet the patient's needs.
• Utilizes statistical analysis techniques to measure clinical and fiscal variances from established patient care guidelines, care designs, protocols and core measures.
• Develops reporting mechanisms to communicate outcomes to physicians and other members of the health care team.
• Supports cost containment efforts through the recommendation of performance improvement opportunities by the health care team.
• Maintains ongoing fiscal awareness by communicating outcomes quarterly to the team.
• Monitors and addresses outcome variances concurrently.
• Identifies causes of outcome variances and implements actions to improve the variances; evaluates corrective actions for improvement.
• Seeks the most efficient, cost-effective ways to provide appropriate care.
• Conducts research to identify 'best' practices for achieving patient outcomes.
• Participates in quality improvement initiatives for assigned population.
• Addresses end of life issues as they arise with the physician, family and other members of the health care team.
• Maintains patient Privacy information with other facilities, services and departments involved in Interdisciplinary Discharge Planning Rounds.
• Provides case management services maintaining the patient's right to privacy and confidentiality adhering to Covenant Health's HIPPA policy.
• Serves as patient advocate in performing case management duties.
• Provides case management services within the scope of practice as a registered nurse meeting all required standards both legal and regulatory.
• Assists with planning, developing and presenting of educational materials designed to foster the patient's and family's understanding of the plan of care.
• Participates in staff development, orientation, and unit meetings through mentoring, consultation, educational presentations and clinical direction.
• Assists with the hiring, supervision, education, orientation, evaluation and disciplining of staff.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Nursing and Residential Care Facilities