We are currently recruiting for (2) RN Case Managers for a 13-week contract assignment in a large acute care facility. Hours are Mon-Fri from 8:00a-4:30p.
Works collaboratively with physicians, staff and other healthcare professionals within his/her Division to coordinate the care and service of selected patient populations across the continuum within the acute care setting.
- Identifies priority patients requiring care management services.
- Collaborates with the patient, family, physician and other healthcare professionals to perform initial and concurrent patient assessment and referrals / recommendations.
- Develops individualized care management care plans in collaboration with patient and family to facilitate care and decrease variances.
- Uses severity of illness/intensity of services indexes to determine appropriateness of admissions, level of care, transfers and continued stays.
- Advocates for adherence to best practice standards through use of approved guidelines, protocols and order sheets.
- Works in conjunction with Utilization Management team in communicating and negotiating with commercial payers or other outside agencies in order to obtain needed services for patients and accurate reimbursement for the organization.
- Identifies opportunities to reduce risks, both financial and clinical.
- Provides important messages from Medicare letters to patients prior to discharge.
- Prepares and provides letters per policy.
- Assesses need for services through multi-disciplinary rounds on patients and collaboration with physicians and other inter-
disciplinary team members.
- Oversees implementation of transition plans with support from internal and external agents.
- Monitors patients' progress and adequacy of planning process through regular communication with patients and service providers.
- Documents actions in medical record according to departmental guidelines and oversees process of exchange of information with other facilities/agencies adhering to legal mandates about confidentiality.
- Monitors and measures effectiveness of care plan interventions through direct communication with patients and caregivers
and review with department leadership of defined indicators (e.g., overall length of stay, readmission rates, feedback from
referral sources, etc.).
- Identifies barriers or gaps in community resources that impact outcomes and discharge.
- Ensures effective hand-offs for discharge home or sub-acute care.
- Provides backup support for Utilization Management.