- Collaboration: Works collaboratively with patients nurses, social workers, physicians, other practitioners, caregivers and community resources and agencies. The case manager and healthcare team are jointly accountable for measurable outcomes that are cost effective and reflect patient preferences and values.
- Contributes to the development of a goal-directed, age-appropriate plan of care through an interdisciplinary team process that is prioritized and based on determined medical diagnosis, patient needs, and expected patient outcomes.
- Interacts with patients and physicians to explore the most appropriate setting to meet patient needs.
- Collaborates daily with physicians and care team members to support the assessment of continued need for acute care hospitalization.
- Participates in the development, implementation, evaluation, and ongoing revision of initiatives to improve quality, continuity, and cost-effectiveness.
- Works collaboratively with other departments and services to define and study areas of inefficiency and participates in process improvement projects.
- Fosters positive internal and external customer relations.
- Communication: Communicates timely, relevant and accurate information to all parties involved with a patient's care.
- Communicates patient needs related to advancing the medical treatment plan and/or discharge plan to appropriate professionals and follows up.
- Communicates continually with patients and families, physicians, care team members, and third-party payors to facilitate coordination of clinical activities and to enhance the effect o a seamless transition from one level of care to another across the continuum, including facilitating and participating in patient care conferences.
- Communicates with patients and families to ensure understanding of third-party payer guidelines and to arrange referrals.
- Provides clear and thorough documentation based on established department standards
- Facilitation: Facilitates the progression of care by advancing the care plan to achieve desired outcomes.
- Develops and documents a discharge plan through collaboration with the interdisciplinary team.
- Ensures that all activities to facilitate and coordinate the plan are being implemented and that the plan is continuously modified based on the patient's changing needs.
- Acts as resource and provides oversight for the Case Management Associate for discharge planning and utilization activities
- Coordination: Integrates the work of the healthcare team by coordinating resources and services necessary to accomplish agreed-upon goals.
- Comprehensively assess patients' goals as well as their biophysical, psychosocial, environmental, economic/financial, and discharge planning needs.
- Procures services and resources for identified patients and families, serving as an advocate to promote achievement of agreed-upon goals.
- Advocacy: Advocates on behalf of patients and caregivers for service access or creation, and for the protection of the patient's health, safety and rights.
- Advocates for the patient, family, physician, and facility to obtain benefits from insurance carriers and others that provide financial assistance for patients and promote health care treatment goals.
- Identifies and reports cases and problems appropriate for secondary review to Case Management Department leadership, the Medical Director, or Physician Advisor.
- Resource Management; Assures prudent utilization of all resources (fiscal, human, environmental, equipment and services) by evaluating the options available and balancing cost and quality to assure the optimal clinical and financial outcomes.
- Assesses the appropriateness and timeliness of level of care, diagnostic testing and clinical procedures, quality and clinical risk issues, and documentation completeness.
- Maintains and documents third-party payers' authorizations, contacts, and transactions for individual patients.
- Accountability: Accepts responsibility and accountability for achievement of optimal outcomes within their scope of practice.
- Seeks out information and resources and uses creative problem solving for complex discharge planning, quality of care, and utilization issues. Explores new resources when the opportunities for the patient are absent or in short supply.
- Continually evaluates case management services and client outcomes.
- Professionalism: Acquires and maintains knowledge and competence related to the expectations of their position and practices within their scope.
- Studies information available to remain informed of reimbursement modalities, community resources, review systems, and clinical and legal issues that affect patients and providers of care.
- Serves as a resource and provides education to patients, physicians, and professional staff on levels of care, quality-of-care issues, and regulatory concerns.
- Provides orientation and mentoring to new staff.
- Works in accordance with applicable state and federal laws and with the unique requirements of reimbursement systems.
- Is knowledgeable about and acts in accordance with laws and procedures regarding patient confidentiality and release of information, Americans with Disabilities Act, other laws protecting rights, and worker's compensation laws when applicable to the case manager's practice.
- Performs other duties requested by the department leadership.
- Bachelor's Degree: Graduate of an accredited Bachelors Nursing degree program or completion of an accredited Nursing program with a Bachelors degree or higher in a health care field or
- Applicants without a BSN degree must actively pursue and attain a BSN within three years of hire. Continued employment by Swedish beyond three years is contingent upon attaining the BSN degree.
- Upon hire: Washington Registered Nurse License
- Three years: Registered nursing experience in an acute care hospital.
- One year: Hospital case management experience.
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Care Manager RN - Pioneer Square, United States - Swedish Health Services
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Description
Description
Care Manager RN @ Swedish Cherry Hill
Per Diem
Day Shift
The nurse case manager coordinates the care and service of selected patient populations through the acute care episode, across the continuum. Works collaboratively with inter-disciplinary teams, both internal and external to the organization, to improve patient care through effective utilization and monitoring of healthcare resources and assumes a leadership role to achieve desired clinical, financial, and resource outcomes.
Providence caregivers are not simply valued – they're invaluable. Join our team at Swedish Cherry Hill and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Required Qualifications:
Preferred Qualifications:
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our mission of improving the health and wellbeing of each patient we serve.
Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
About the Team
Providence Swedish is the largest not-for-profit health care system in the greater Puget Sound area. It is comprised of eight hospital campuses (Ballard, Edmonds, Everett, Centralia, Cherry Hill (Seattle), First Hill (Seattle), Issaquah and Olympia); emergency rooms and specialty centers in Redmond (East King County) and the Mill Creek area in Everett; and Providence Swedish Medical Group, a network of 190+ primary care and specialty care locations throughout the Puget Sound. Whether through physician clinics, education, research and innovation or other outreach, we're dedicated to improving the wellbeing of rural and urban communities by expanding access to quality health care for all.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID:
Company: Swedish Jobs
Job Category: Care Management
Job Function: Clinical Care
Job Schedule: Per-Diem
Job Shift: Day
Career Track: Nursing
Department: 3903 SCH CASE MANAGEMENT
Address: WA Seattle 500 17th Ave
Work Location: Swedish Cherry Hill 500 17th-Seattle
Pay Range: $ $74.61
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
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