RN Case Manager, Mary and Elizabeth Hospital, Weekend

UofL Health•Louisville, KY

3d•Onsite

About The Position

The RN Case Manager Weekend promotes optimal health care outcomes in accordance with UofL Health policies, procedures, applicable laws and contracts, and the organization’s philosophy, mission, vision and values. The role is accountable for appropriate utilization of facilities and services; serves as a resource to physicians, nurses and ancillary staff; conducts admission assessments; identifies patients who may not meet criteria for their current level of care; and helps ensure patients receive the most appropriate care. The RN Case Manager participates in daily rapid rounds and works with the interdisciplinary healthcare team to coordinate care and discharge planning. The role uses nursing and management processes to guide decisions, maintains confidentiality, and supports organizational goals by providing information to divisions and departments. Under the direction of the Manager or Director of Care Coordination or CNO, the RN Case Manager performs assessments and ongoing reviews, develops and documents patient-specific care plans, coordinates discharge needs, and documents work in accordance with quality review standards. The position advocates for patients and families, facilitates communication across the care team, supports Medicare notice delivery where applicable, and completes case management consults in the electronic medical record. The RN Case Manager also works with social workers, educates physicians, patients and staff on payor, financial, documentation and compliance matters, and maintains professional competency and compliance with organizational and HIPAA requirements.

Requirements

Associate degree in Nursing while actively pursuing a BSN, or a bachelor’s degree in Business, Health Care Administration or equivalent; bachelor’s completion is required within three years of hire.
Two years of experience as an RN.
Current Kentucky RN license or compact license with privileges to work in Kentucky.
Basic Life Saving (BLS) certification accredited by the American Heart Association.
Ability to adjust priorities quickly, organize multiple tasks simultaneously and work interdependently with staff at multiple levels.
Attention to detail and strong organizational skills.
Ability to adjust work hours based on departmental and organizational needs as determined by the director, manager or CAO.
Knowledge of state laws, CMS conditions of participation and TJC standards related to care management and discharge planning.
Effective verbal and written communication skills.
Ability to critically think through complex patient situations, process improvements and evidence-based practice; break down problems and identify causes and consequences; and proactively solve problems.
Proficiency in Microsoft Word, Excel and Outlook, and basic computer skills including use of electronic medical records.
Commitment to service, organizational values and professionalism; ability to maintain confidentiality, protect sensitive data, follow safety guidelines, collaborate with team members and interact effectively with healthcare stakeholders.

Nice To Haves

Bachelor of Science in Nursing or RN with a bachelor’s degree in Business, Health Care Administration or equivalent.
One additional year of discharge planning or case management experience in an acute care facility.
Case Management Certification (ACM, ANCC-Nurse Case Manager or CCM).

Responsibilities

Conduct timely initial admission assessments using clinical indicators and anticipated service needs, verify the appropriate level of hospital care, and validate patient demographics and payor source.
Contribute to multidisciplinary clinical assessments and reassess patients throughout their admission to support quality and appropriate care.
Implement, reassess and evaluate patient condition; coordinate the plan of care daily and document updated patient-specific plans in the electronic medical record.
Coordinate patient discharge needs with internal and external providers while protecting patient information.
Complete timely and appropriate documentation in accordance with the Quality Review Audit process.
Advocate respectfully and confidentially for patient and family needs.
Facilitate communication between patients and the interdisciplinary healthcare team, educate the team about the RN Case Manager role, and serve as an accessible resource.
Refer unresolved cases to the Manager or Director of Care Coordination, CAO or medical director when intensity of service or severity of illness criteria are not present.
Ensure delivery of the Medicare Important Message and Medicare Outpatient Observation Notice when applicable.
Acknowledge, address and complete case management consults for assigned units in the electronic medical record.
Work with social workers to identify social and financial barriers and community resources, and refer patients with high-risk indicators to a social worker.
Attend monthly departmental staff communications meetings and participate in committees and projects as needed.
Maintain professional growth and competency through educational programs, current literature, in-service meetings and workshops.
Educate physicians, patients and staff about payors, financial issues, documentation and potential compliance issues.
Serve as a resource to physicians on clinical management and financial issues and help promote efficient care delivery and reduce barriers to service.
Comply with company policies, procedures, standards of conduct, HIPAA privacy and security requirements, and applicable safety guidelines.
Collaborate with and support team members, demonstrate professionalism and customer service, and perform other duties as assigned.