case mgnt specialist - Bay City, United States - Covenant HealthCare

Description

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Covenant HealthCare

US:
MI:SAGINAW

8:00 AM - 4:30 PM, MONDAY - FRIDAY

FULL TIME BENEFITED

Summary:

The Case Management Specialist (RN) and demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to Extraordinary Care for Every Generation.

The purpose of the Case Management Specialist position is to work with an assigned patient population to promote the achievement of optimal clinical and resource outcomes.

Responsible for managing appropriate lengths of stay for all hospital admissions in accordance with its goals and objectives. Acts as the key information and education resource for the multidisciplinaryteam.

Works to develop organization-wide approaches to problem solving, analyzes current systems and variances to identify opportunities for improvement and works to promote quality of care through collaboration with all service team members, patients, and families.

Works with the leadership team to align the goals and vision.

The Case Management Specialist plans effectively in order to meet patient needs, manage the length of stay, and promote efficient utilization of resources.

Responsibilities:

Facilitation of the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery.

Facilitate transfer of patients to the most appropriate level of care and in accordance with CMS Discharge Planning regulations.

Coordination of care for the patient during their hospital stay and effect appropriate and timely transition to sub-acute setting that best meet the patient's needs.

Coordination of communication with physicians.
Float to other units where support is needed by another Case Managers
Participate in Process Improvement methodologies in evaluating outcomes of care and interventions.
Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the patient population served.
Must demonstrate knowledge of the principles of growth and development as it relates to the different life cycles.

Specific age groups that are served by this position are noted below:

*Neonatal/Newborn (birth - 30 days) - PEDS, NICU, OB, ECC
*Infant (30 days - 1 year) - PEDS, NICU, ECC
*Pediatric years) - PEDS, ECC
*Adolescent years) - OB, M/S, CC, ECC
*Adult years) - OB, M/S, CC, ECC
*Geriatric (65+ years) - M/S, CC, ESS
Serves as a patient and family advocate.
Contributes to organizational targets for length of stay reductions overall and for Hospital Medicine.
Builds relationships within the organization serves as a resource to the healthcare team related to discharge planning.
Collaborates and facilities multidisciplinary rounds and care with physicians and all other members of the team including the patient and their family to:
oEnsure continuity, timeliness, and appropriateness of care for designated case load.

oMonitors the patient's progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient, and cost effective.

oEnsures timely completion and reporting of diagnostic testing, initiation, and completion of treatment plan and all required documentation.
oFacilitate and coordinate transfers of patients to other facilities
Reviews cases for quality or risk management issues and intervenes when indicated.
Involved in the process of presenting notices of non-coverage

Maintains an understanding of reimbursement methods and monitors cost-effective care, therefore, preventing duplication or fragmentation of care and curtailing operational and clinical delays.

Identifies patients with potential for extended length of stay or variances and collaborates with multidisciplinary team to develop interventions to correct the issues.

Evaluates effectiveness of interventions on outcomes that measure cost and quality such as LOS and variances from expected outcomes.
Interprets patient response and collaboratively identifies interventions to maximize positive outcomes.

Works with the Healthcare team to demonstrate fiscal responsibility by being conscious of the need to appropriately use the resource dollars available and identify and pursue opportunities.

Helps to implement standards of care, standards of practice, hospital policies and critical pathways.
Through case management efforts, assists in meeting all accreditation and licensing processes.
Actively prepares and participates in accrediting agency surveys.
Assists in planning, implementing, and evaluating quality improvement.
Manages conflict effectively, striving for win-win outcomes.
Engage in continuing education to improve knowledge, skills and maintain CEU's for licensure.
Maintains patient confidentiality according to all applicable laws, policies, and regulations.

Other information:
EDUCATION/EXPERIENCE
RN with current license in State of Michigan
Minimum of Associates degree in nursing with 2 years of bedside nursing, 5 years in an acute care setting and 5 years of case management experience
OR RN with a bachelor's degree in healthcare related field or will be working toward completion of bachelor's degree within 6 months and completion of program within 3 years, minimum of 3 years clinical experience
Current master's level SW clinical license with State of Michigan required or able to obtain within 6 months of hire (Licensed or Limited License)
Minimum of three years' experience in a healthcare facility or related community agency preferred.
Charge responsibility experience strongly preferred.
KNOWLEDGE/SKILLS/ABILITIES
Demonstrated clinical competence.
Has exceptional understanding of the disease process and... For full info follow application link.
Covenant HealthCare is an equal opportunity employer.

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