Case Manager - Providence, United States - The Miriam Hospital
Description
Summary:
Summary:
Reports to the Manager or Director of Case Management. Provides coordinated care support to facilitate and expedite patient care services.
Participates in daily rounds and collaborates with the clinical healthcare team across the patient care continuum to include preadmission and post hospital discharge.
As a member of that team shares responsibility for the implementation of the discharge plan; ensures efficient and effective delivery of patient care services through the appropriate utilization of healthcare resources.
Full time part time per diem and job share schedules available.
Responsibilities:
Responsibilities:
Partners with medical staff and other members of the healthcare team in collaboration with the patient/family to facilitate the plan of care for a defined patient population across the continuum of care.
Identifies a high-risk patient population within the caseload for care management assessment screening and targets interventions in conjunction with the healthcare team within one business day of patient admission.
Participates in daily care rounds to collaborate with members of the patient's healthcare team as well as to evaluate and facilitate development and implementation of the discharge planning process.
Proactively builds post hospital referrals and sends to the Transition Care Coordinator when indicated to facilitate timely discharge.
Delivers Important Message follow-up notices to all Medicare patients according to CMS regulations. Follows CMS and DOH regulations in relationship to discharge guidelines and patient rights.
Coordinates the length of stay with the physician care team and patient. Ensures team is informed of insurance qualifiers that may affect the discharge plan. Discuss approaching discharge readiness of patients. Identify and assess readmitted patients and complex patients in collaboration with members of the healthcare team to coordinate discharge.
Advocates for the patient and advises the patient regarding financial implications of their discharge plan when coordinating care for the patient.
Documents final discharge disposition in progress notes.
Develops appropriate patient care reports to ensure safe patient handovers occur as a patient is transferred from one patient care area to the next.
Provides care plan direction for the advancement of a patient care delivery system which supports managed care strategies and decreases readmission risk.
Acts as a change agent by identifying opportunities to improve patient flow and reduce service delays through problem resolution and follow-up.
Demonstrates knowledge of federal and state rules and regulations.
Reviews and acts as a change agent by identifying opportunities to improve patient flow and identifies and reduces service delays through problem resolution and follow-up.
Participates in departmental and/or interdepartmental quality improvement activities as requested: i.e. OpX teams weekly long LOS reviews interdisciplinary rounds readmission reviews. Participates in Orienting of New staff as requested.
Participates in ongoing education-related professional activities and affiliations to maintain an advanced level of knowledge of patient care services third party payer and managed care requirements and case management.
Other information:
Licensure as Registered Nurse in the State of Rhode Island by the Rhode Island Board of Nursing
or licensure as a Registered Nurse in accordance with the Nurse Licensure Compact agreement of the National Council of State Boards of Nursing.
BASIC KNOWLEDGE:
Graduate of a School of Nursing with current license to practice as a Registered Nurse in the State of Rhode Island.
Certification in Case Management by a nationally organization preferred or to be obtained within 1 year of hire.
AHA BLS Provider required.
EXPERIENCE:
Three years of clinical experience with recent experience in case management community case management patient navigation or discharge planning is strongly preferred.
Strong analytical and interpersonal skills are required to provide guidance to and communicate daily with healthcare professionals patients and families.
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