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Emergency Department Case Manager Full Time 2nd Shift - Louisville, United States - Baptist Health System KY & IN
Description
Description
:Job Summary
This registered nurse position is responsible for screening potential ED hospital admissions using established criteria (InterQual) for appropriateness of hospital admission, correct patient status and appropriate level of care. This position requires extensive communication with ED staff, Attending and ED physicians, Room Reservations and Patient Access personnel. Scheduling will require flexibility to provide adequate ED coverage during high occupancy periods.
Principal Duties and Responsibilities
1. Screens potential admissions using InterQual criteria for appropriateness of hospital admission and refers for secondary review per procedure.
2. Assists with patient placement to the appropriate level of care based on results of screening and unit ability to meet ongoing patient care needs
3. Initiates appropriate action to resolve clinical and operational delays impeding progression of the patient.
4. Effectively communicates with other healthcare providers as well as patient/families in matching the patient's care needs with available resources and services
5. Facilitates/performs discharge planning that may include patient education, follow-up appointments, community resources, institutional referrals or other alternate settings,
medical supplies, prescriptions.
6. Enhances understanding of the Cooperative Care Program through availability and interactions with patients/ families and all health care providers. Serves as resource to nursing staff and physicians.
7. May initiate insurance authorizations for plans requiring 24h notification or have on-line authorization processes.
8. Functions in role of a continuous improvement motivator utilizing advanced problem-solving skills.
9. Implements cost and resource management strategies.
10. Promote quality improvement by identifying and intervening in - Quality of care issues - Abnormal lab, etc., not addressed - Inappropriate antibiotic/medication use - Inappropriate blood/blood product use - Deficient clinical documentation - Risk Management and Infection Control Issues
11. Develops and maintains good working relationships with Cooperative Care unit teams, hospital and medical staff, and personnel from community health, welfare and social service agencies.
12. Demonstrates knowledge of growth and development and coordinates case management process for the age specific population.
13. Performs other duties as requested by the manager.
Minimum Education, Training, and Experience
RN with at least 5 years of experience in acute care nursing required.
Active Kentucky RN License
BSN preferred
Utilization review/discharge planning, case management experience preferred. CCM preferred.
Baptist Health is an employer.
