RN Case Manager, Mary and Elizabeth Hospital, Weekend

UofL Health•Elizabeth, NJ

2d•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 use of facilities and services and serves as a resource to physicians, nurses, and ancillary staff. The RN Case Manager conducts initial admission assessments, identifies patients who do not meet criteria, and takes action to ensure patients receive the most appropriate level of care. The position participates in daily rapid rounds to coordinate care and facilitate health care and discharge planning with the interdisciplinary team. It uses nursing and management processes to support decision-making, protects confidential information, 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 supports the Care Coordination Department through admission and ongoing clinical assessments, development and documentation of patient-specific plans of care, coordination of discharge needs, and timely documentation. The role advocates for patients and families, serves as a liaison and resource to the interdisciplinary team, escalates cases when appropriate, and ensures delivery of required Medicare notices. Additional duties include working with social workers, educating physicians, patients, and staff, participating in meetings and committees, maintaining professional competency, complying with organizational policies and HIPAA requirements, and performing other assigned duties.

Requirements

Associate Degree in Nursing if actively pursuing a BSN, or a bachelor’s degree in Business, Health Care Administration, or equivalent, with bachelor’s degree completion 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 (AHA).
Ability to adjust priorities quickly, organize multiple tasks simultaneously, and work interdependently with staff at many 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 Chief Administrative Officer (CAO).
Knowledge of state laws, CMS conditions of participation, and TJC standards concerning care management and discharge-planning regulatory requirements.
Effective verbal and written communication skills.
Ability to critically think through complex patient situations, process improvements, and evidence-based practice.
Ability to break down problems or tasks and use knowledge and experience to identify causes and consequences.
Strong problem-solving skills and a proactive approach to resolving issues.
Proficiency in Microsoft Word, Excel, and Outlook.
Basic computer skills, including use of electronic medical records.
Commitment to organizational values and professionalism; ability to maintain confidentiality and protect sensitive data; and ability to work collaboratively and provide exceptional customer service.

Nice To Haves

Bachelor’s Degree 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 to support the appropriate level of hospital care, and validate patient demographics and payor source.
Contribute to multidisciplinary clinical assessments throughout the patient’s admission to support quality and appropriateness of care.
Implement, reassess, and evaluate patient condition and coordinate the plan of care daily.
Develop patient-specific plans of care based on patient needs, conversations with providers and staff, and electronic medical record documentation; ensure the updated plan is documented in the EMR.
Coordinate patient discharge needs with internal and external providers while protecting patient information.
Complete timely, professional, and appropriate documentation as reflected in the Quality Review Audit process.
Advocate respectfully, non-judgmentally, and confidentially for patient and family needs.
Serve as a liaison and facilitator for patients and the interdisciplinary health care team in unusual or questioned cases; educate the team about the RN Case Manager role and remain accessible as a resource.
Refer cases to the manager or director of care coordination, CAO, or medical director when intensity of service or severity of illness is not present and the issue cannot be resolved.
Ensure delivery of the Discharge Medicare Important Message (IM) and Medicare Outpatient Observation Notice (MOON), where applicable.
Acknowledge, address, and complete Case Management consults for respective units in the EMR.
Work collaboratively with social workers to identify social and financial barriers and community resources.
Refer patients with high-risk indicators to a social worker.
Attend monthly departmental staff communications meetings and participate in committees as needed.
Pursue professional growth and development through education, current literature, in-service meetings, and workshops; maintain competency in care management principles.
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; assist providers in promoting care-delivery efficiencies and reducing or eliminating barriers to effective service.
Comply with company policies, procedures, standards of conduct, HIPAA privacy and security requirements, and applicable safety standards.
Demonstrate professionalism, service, organizational values, teamwork, and effective customer service in interactions with patients, providers, staff, visitors, and the broader health care community.
Perform other duties as assigned.