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Registered Nurse Case Manager

Company: Wyoming Medical Center
Location: Casper
Posted on: July 11, 2019

Job Description:

The Case Manager RN focuses on integrating case management, social services, discharge planning, utilization review, and pre-hospital services to ensure clinical efficacy. The Case Manager works to ensure provision of quality health care along the acute continuum, decrease fragmentation, enhance the patient's quality of life, and efficiently use patient care resources, while maximizing cost containment opportunities. The Case Manager guides the integrated model team in the functions of care coordination, facilitation of referrals, education, advocacy, discharge planning, utilization management, and outcomes driven by evidence-based practices. Duties and Responsibilities:

  • The employee shall comply with all safety and health standards, and all rules, regulations, and orders which are applicable to the individual's own position, actions, and conduct.
  • Coordinates and guides the integrated care team to provide a timely course of care for at-risk or resource-intense inpatients in assigned specialty area(s).
  • Assesses patient's clinical course, provides ongoing patient care coordination, verifies patient's need for acute hospital level of care, and identifies discharge planning needs. Assesses patient and family adaptations to illness or disability and capacity to provide for patient's care needs. Identifies obstacles to discharge.
  • Collaborates with physicians, nurses, and other disciplines to foster a coordinated approach to the patient's care.
  • Assists medical staff to investigate and resolve problems and concerns related to the patient's care.
  • Identifies and facilitates resolution of process issues to avoid delays in patient care.
  • Intervenes with appropriate individuals or departments to avoid or minimize delays in service that may have an impact on quality of care and/or length of stay. Provides feedback to unit management regarding delays in patient care services.
  • Facilitates development or revision of care pathways in parallel with best practices and order sets, in collaboration as appropriate with physicians and support services.
  • Seeks peer and supervisor consultation regarding problematic cases or cases demonstrating deviations from the plan of care.
  • Facilitates the clinical progression for a patient population through tracking outcomes.
  • Provides in-service training and collaborates with clinical staff.
  • Champions current evidence-based clinical practice guidelines. Initiates and develops improved practices in collaboration with clinical staff. Seeks educational opportunities within the primary work environment. Evaluates current research and studies and applies findings to improve case management practice and service delivery.
  • Assures referrals for discharge planning are timely and appropriate.
  • Serves as a resource for and appropriately disseminates data.
  • Identifies and monitors complex patient population to reduce readmission rate and improve outcomes.
  • Through optimal combination of services and education, maximizes functional capacity of patient for self care, assisted living, or transitional placement as appropriate.
  • Reviews clinical documentation to ensure accurate assignment of Diagnosis Related Group (DRG) codes and physician documentation.
  • Documents in appropriate area of medical record and assures appropriate accessibility of documentation to other health care providers.
  • Notifies physician of care continuum issues related to insurable coverage and collaborates in resolving issues in the best interests of the patient.
  • Resolves quality or risk management issues or appropriately refers them for corrective action.
  • Acts as the patient's advocate throughout the care continuum.
  • Stays current with research and trends in evidence-based practice related to specialty area and assignments.
  • Participates in nursing unit and department clinical outcome projects.
  • Facilitates standardization of patient education with specific patient care units.
  • Participates in shared governance structures appropriate to responsibilities and interests, to improve nursing practice and patient care. Participates in department staff meetings. Serves on hospital and/or nursing committees as appointed or requested. Participates in task force activities.
  • Practices quality management according to Joint Commission and OSHA standards and regulatory guidelines. Applies regulatory requirements to practice (e.g. HIPAA, CMS, Joint Commission, URAC, etc.).
  • Leads activities to promote and strengthen team cohesiveness and effective performance.
  • Exhibits strong relationship-building skills with medical staff, clinical staff, and management.
  • Reflects cost awareness, concern for cost containment, and conservation of resources in activities.
  • Demonstrates and models openness to change and willingness to try new approaches and systems.
  • Keeps Director of Care Management Services and Director of Patient Care Services apprised of developments, progress, and barriers.
  • Conducts self in a professional manner, using accountable communication to resolve problems in an open, timely manner. Demonstrates professional relations at all times with patients, families, physicians, co-workers, and the public.
  • Where the Case Manager is an RN: As requested or needed, performs duties and responsibilities within the scope of a Registered Professional Nurse as defined by the Wyoming Nurse Practice Act and Wyoming Medical Center policies and procedures.
  • Performs additional duties as assigned. Requirements
    • ---\tAcute care experience

Keywords: Wyoming Medical Center, Casper , Registered Nurse Case Manager, Executive , Casper, Wyoming

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