RN, Inpatient Case Manager - ED, Fulltime (Night - Weekend), Emory Saint Josephs
Company: Health eCareers
Location: Atlanta
Posted on: October 3, 2024
Job Description:
$10,000 SIGN-ON BONUS FOR ELIGIBLE EXTERNAL HIRESJob
SummaryResponsible for working collaboratively with physician
partners to optimize quality and efficiency of care for
hospitalized members by carrying out daily utilization and quality
review, monitoring for inefficiencies and opportunities to improve
care, developing a safe discharge plan to include recommending
alternative levels and sites of care when appropriate. The
activities will include daily review of hospital care by chart
review and discussion with attending physician, admission and
concurrent review for inpatient admissions, meetings with patient
and families to develop discharge planning, identification of
patients for ambulatory case management, communication with case
managers, home care reviewers, social workers, members and
providers, quality improvement reviews, and education of the
member/family, provider and hospital staff. Achieves desired
utilization and quality outcomes and promotes high customer
satisfaction to the population served.Essential
Responsibilities
- Plans, develops, assesses and evaluates care provided to
members. Collaborates with physicians, other members of the
multidisciplinary health care team and patient/family in the
development, implementation and documentation of appropriate,
individualized plans of care to ensure continuity, quality and
appropriate resource use. Reviews, monitors, evaluates and
coordinates the patients hospital stay to assure that all
appropriate and essential services are delivered timely and
efficiently. Communicates via huddles with hospitalist partner
multiple times throughout the day.
- Reviews all new inpatient admissions within 24 hours and begins
the discharge planning process immediately. Assesses high risk
patients in need of post-hospital care planning. Develops and
coordinates the implementation of a discharge plan to meet each
patients identified needs; communicates the plan to physicians,
patient, family/caregivers, staff and appropriate community
agencies to enhance the effect of a seamless transition from one
level of care to another across the continuum. Ensures that the
appropriate level of care is being delivered in the most
appropriate setting. Recommends alternative levels of care and
ensures compliance with federal, state and local requirements.
- Performs psychosocial assessments on all patients that meet the
high risk indicators for discharge planning. Comprehensively
assesses patients goals as well as their biophysical, psychosocial,
environmental, economic/financial, and discharge planning needs.
Provides patients with education to assist with their discharge and
help them cope with psychological problems related to acute and
chronic illness. Refers patients to the ambulatory case managers,
care managers and/or social workers as appropriate. Documents all
admissions and discharges in the patients Kaiser Permanente
electronic medical record. Makes post discharge follow-up calls to
all patients who are not referred to an ambulatory case/care
management program.
- Attends scheduled rounds 2 times/week with the Physician
Director of Resource Stewardship to discuss clinical course and
discharge planning for assigned patients identifying any real or
potential delays in care or quality of care issues.
- Acts as a liaison between inpatient facility and referral
facilities/agencies and provides case management to patients
referred, serving as an advocate for patients and families.
Coordinates transfer of patients to appropriate facilities;
maintains and provides required documentation. Builds highly
effective working relationships with physicians, SNF staff,
vendors, and other departments within the health
plan.ExperienceBasic Qualifications:
- Minimum two (2) years of experience in patient care delivery or
completion of Masters degree in Case Management Program in lieu of
minimum years of experience.Education
- Associates Degree Nursing.License, Certification, Registration
- Registered Professional Nurse License (Georgia)
- Licensed Registered Nurse (Temporary - Georgia)Additional
Requirements
- Demonstrated advanced communication and interpersonal skills
with all levels of internal & external customers, including but not
limited to medical staff, patients and families, clinical
personnel, support and technical staff, outside agencies, and
members of the community.
- Ability to collaborate effectively with multidisciplinary
healthcare team.
- Excellent time management skills with the ability to work
successfully in a fast-paced environment. Must be self-directed,
and have the ability to tolerate frequent interruptions and a
demanding work load.
- Functional knowledge of computers.
- Experience with managed health care delivery including
Medicare.
- Experience in a payer environment highly desirable.
- Knowledge of funding, resources, services, clinical standards,
and outcomes is preferred.
- Complex Case Management Certification preferred.
- Knowledge of the Nurse Practice Act, TJC, DMHC, CMS, NCQA,
HIPPA, ERISA, EMTALA & all other applicable federal/state/local
laws & regulations.
- Demonstrated strong communication and customer service skills,
problem-solving, critical thinking, & clinical judgment
abilities.
- Fundamental word processing & computer navigation skills & the
ability to interpret & use analytic data in day to day
operations.
- Knowledge of healthcare benefits associated with various
business lines.Preferred Qualifications
- Minimum five (5) years of clinical nursing experience in a
hospital setting.
- Minimum five (5) years of professional practice experience in
an acute care setting.
- Minimum two (2) years of experience in utilization review, case
management, and discharge planning preferred.
- Bachelors Degree in Nursing, Health Care or Masters degree in
Case Management.
Keywords: Health eCareers, Warner Robins , RN, Inpatient Case Manager - ED, Fulltime (Night - Weekend), Emory Saint Josephs, Executive , Atlanta, Georgia
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