Registered Nurse Case Manager
Company: Wyoming Medical Center
Posted on: July 11, 2019
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
- 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
- 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
- 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
- Assures referrals for discharge planning are timely and
- Serves as a resource for and appropriately disseminates
- 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
- Documents in appropriate area of medical record and assures
appropriate accessibility of documentation to other health care
- 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
- Stays current with research and trends in evidence-based
practice related to specialty area and assignments.
- Participates in nursing unit and department clinical outcome
- 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,
- 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
- 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
- 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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