Description
Job Description
Are you interested in a nursing career in Care Management? As a RN Case Manager at Peacehealth, you'll join our Care Management team in a rewarding career collaborating with an interdisciplinary healthcare team to assess and coordinate our patients' needs for services and plan for discharge.
Consider the following position with us:
- Full-time 1.0 FTE RN Case Manager
- 8 - hour day shifts, 8am - 4:30pm
- Provide case management for our inpatient population
We offer you:
- A current wage range of $53.80 - $80.06, hiring rate is dependent upon several factors including RN experience and terms of the WSNA Bargaining Agreement.
- Additional compensation for BSN, MSN, DPN, and specialty nursing certification
- Hiring Bonus
- Relocation Assistance
- Professional Nurse Advancement Program with pay incentives
- Comprehensive benefits package effective the first of the month following start date.
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Position Summary: Responsible for coordinating and monitoring the patient's care including the daily plan and the plan for the stay. Performs patient care review activities including monitoring and correcting patient status, documentation for medical necessity of admission and continued hospitalization and concurrent review. Educates patients and families about their hospital course and identifying patient's discharge needs.
Position Details:
- Provide initial and ongoing assessments of the patients’ needs for services in collaboration with the healthcare team. Monitor and evaluate utilization of those services to focus on the best treatment and approach for the patient promoting the timely progression of interventions, utilization of resources and expected outcomes within a length of stay consistent with external regulations and standards.
- Provide utilization management including facilitating appropriate status assignment per Medicare and InterQual criteria. Ensure appropriate documentation for medical necessity of admission and continued hospitalization. Ensure appropriate level of care bed assignment, apply/interpret payer criteria to ensure conformance with payer standards and provide insurance reviews. Implement opportunities to improve effectiveness in utilization.
- Provide transition planning coordination to include identifying needs and implementing referrals to other clinical care providers. Evaluate patient progress and revise the care plan if needed. Act as a resource for physician office, physician and staff regarding Intensity Severity Discharge (ISD) criteria. Identify barriers to achieving patients discharge and assist the care team in overcoming them.
- Provide patient/family education to facilitate an understanding of their hospital and post-hospital course, their status assignment and discharge appeal rights and provide advocacy for their care.
- Effectively communicate and provide clear and concise documentation according to department standards and regulatory requirements. Refer to appropriate internal and community resources as necessary.
- Act as care management resource by demonstrating critical thinking, portraying a professional image of competency to customer and staff and demonstrating effective verbal and written communication with everyone. Maintain knowledge of CMS, Medicaid, and regulatory agency standards, Department of Health (DOH), Emergency Medical Treatment and Active Labor Act (EMTALA). Serve as a clinical resource and/or liaison.
- Lead “progression of care” transition rounds, assigning cases to MSW/Discharge planner for intervention.
- Within the Emergency Department Case Manager role: coordinate alternative level transfers (SNF, ALF, ICF, home health), coordinate equipment and other discharge resources.
- Performs other duties as assigned.
Qualifications
- Required: Accredited School of Nursing
- Required: Minimum of 3 years RN experience in a hospital setting with medical/surgical experience with supervisory/preceptor experience (or may have equivalent combination of education and/or experience)
- Required: WA State Registered Nurse License or current MSL
- Required Upon Hire: Healthcare provider Basic Life Support Certification
Preferred:
- Bachelor's Degree Preferred: Bachelor of Science in Nursing
- 1 year Surgical patient population experience
- Certified Case Manager
Skills
- Discharge planning, case management, quality assurance/quality improvement, clinical documentation and/or utilization management using Intensity Severity Discharge (ISD). (Preferred)
- Strong verbal, written and interpersonal communication skills. (Required)
- Extensive knowledge of diseases, clinical procedures, treatment, prognosis and hospital functions. (Required)
- Ability to effectively communicate clinical information. (Required)
- Strong analysis/problem solving skills. (Required)
- Skill in the evaluation of quality and appropriateness of care. (Required)
- Proven leadership ability. Strong organization skills with the ability to work in a fast-paced environment independently or as part of an interdisciplinary team. (Required)
- Computer skills to include proficiency in keyboarding and data entry. (Required)
- Critical thinking skills, able to assess, evaluate and teach. (Required)
- Knowledge of discharge planning, health care reimbursement, utilization review processes and Medicare admission status/classification level. (Required)
- MS Office proficiency. (Preferred)
Working Conditions
Lifting
- Patient handling no greater than 35 lbs. without the use of assistive equipment and/or devices (NIOSH).
- Fine motor skills to be able to grasp and control medical equipment and perform precise procedures.
- Push/Pull: Frequently up to 45 lbs. force (i.e., WOW, medical carts).
- Perform hands on CPR at least 20 mins using 100-125 lbs. of force (National Assoc. of EMS Physicians and AHA) Frequency should be seldom or occasionally.
- Ability to move around area with frequent sitting.
- Bending/ stooping/ squatting/ reaching/ kneeling frequently.
- Lifting (non-patient) up to 20 lbs. occasionally and 5 lbs. frequently.
Environmental Conditions
- Exposure to biohazard, body fluids and airborne particles.
- Must be able to complete tasks in a noisy environment.
Mental/Visual
- Vision and hearing required within normal limits (glasses, contacts, hearing aids permitted).
- Ability to communicate and exchange accurate information.
This position is represented by a collective bargaining agreement. There may be more than one opening on this posting
PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.
See how PeaceHealth is committed to
For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state, or federal laws.
