RN Case Manager (PRN)

Ventura•Ventura, CA

1d•Onsite

About The Position

The PRN RN Case Manager works collaboratively with patients, families, and the healthcare team to develop discharge plans and coordinate necessary post-acute care services. Additionally, the PRN RN Case Manager I assists with gathering data to ensure that patient care meets approved admission criteria, continued stay requirements, and the appropriate level of care. The PRN RN Case Manager is a registered nurse with basic knowledge of case management principles and limited experience in the practical application of case management practices.

Requirements

Associate Degree in Nursing (ADN)
Current CA Registered Nurse (RN) license
Current Basic Life Support (BLS) certification

Nice To Haves

Bachelor's of Science in Nursing (BSN)
Bilingual in Spanish
Previous experience with InterQual
Previous experience with Allscripts, Meditech, or Epic

Responsibilities

Acts as a liaison between physicians, nursing, other hospital departments, community agencies, health plans, patients, and families.
Conducts discharge and transitional care planning.
Involves and educates patients and families regarding discharge planning and community resources.
Collaborates with appropriate community resources on behalf of patients.
Refers patients to Social Services when appropriate.
Refers quality-of-care issues according to established policies and procedures.
Reports suspected or actual abuse.
Participates in Process Improvement activities.
Works independently while collaborating with the Lead Case Manager or Manager as a resource for challenging discharges and exercises sound judgment in interactions with physicians, payers, patients, and families.
Demonstrates strong organizational and time management skills, as evidenced by the ability to prioritize multiple tasks and role responsibilities.
Applies approved clinical criteria to monitor admissions and continued stays and documents findings according to department standards.
Pursues authorizations for acute stays and potential needs from third-party payers.
Monitors length of stay (LOS) and ancillary resource utilization on an ongoing basis.
Takes appropriate action and discusses potential delays and/or LOS concerns with physicians.
Understands and acts in compliance with Medicare regulations.
Facilitates patients' right to appeal.
Assesses for and facilitates transitions of care and maintains communication with post-acute providers.
Utilizes critical thinking skills and judgment to evaluate the clinical and psychosocial condition of patients.
Effectively manages and teams cases with Social Work, the Palliative Care team, and Intensive Case Management.
Ensures that patient evaluations are complete and reflect a comprehensive assessment of the patient.
Ensures that the discharge plan is in place in a timely manner.
Promotes individual professional growth and development by meeting requirements for mandatory and continuing education and skills competency.
Supports department-based goals.
Serves as a preceptor, mentor, and resource to less experienced staff.
Performs other duties as assigned.