Case Management Society of America (CMSA) ®
RN Case Manager
Case Management Society of America (CMSA) ®, Oregon, Wisconsin, United States, 53575
POSITION OVERVIEW
TITLE:
RN, Case Manager REPORTS TO POSITION:
Manager of Care Coordination DEPARTMENT:
Care Coordination DATE LAST REVIEWED:
December 9, 2021 OUR VISION:
Creating Americas healthiest community, together OUR MISSION:
In the spirit of love and compassion, better health, better care, better value OUR VALUES:
Accountability, Caring and Teamwork DEPARTMENTAL SUMMARY:
The Case Management Department at St. Charles Health System engages in a collaborative process that assesses, plans, implements, coordinates, monitors and evaluates the options and services required to meet the client\'s health and human service needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost- effective interventions and outcomes. The RN Case Manager provides clinically based case management to support the delivery of effective and efficient patient care. This position has accountability for utilization management and discharge planning for patients within the assigned caseload. The Case Manager collaborates with the health care team to identify appropriate utilization of resources. This position does not directly manage other caregivers.
ESSENTIAL FUNCTIONS AND DUTIES
Utilizes the nursing process (assessment, diagnosis, planning, intervention, evaluation) to assess the patient\'s condition and needs; set outcomes; implement nursing actions; and evaluate progress. Uses criteria to confirm medical necessity for continued stay; in coordination with the patient, family and health care team, creates a discharge plan. Collaborates with team members to facilitate patient and family learning; reinforces continued health care through teaching and/or referrals. Partners with physician, hospital administration, patient/family, peers, and other disciplines to implement and document the discharge plan; documents in the patient record per SCHC policies. Supports outcomes such as reduced length of stay, reduced cost per discharge, improved discharge procedures, patient satisfaction, and interdisciplinary communication; evaluates continued stay for appropriateness. Manages clinical aspects of discharge planning, including post-discharge needs, wound care, Rehab Center placement updates, medication procurement for initial 30 days, primary care physician assignment and complex discharge issues. Identifies barriers to discharge or transfer and leads resolution efforts; schedules and leads complex discharge rounds and conferences with patient, family and the team. Acts as patient care facilitator and liaison to internal services and external agencies. Provides staff education and participates in quality improvement activities related to case management. Provides cross-over coverage for other units/sites as needed. Supports a healing environment and intentional relationships to enhance the care experience. Delivers therapeutic presence and effective communication with patients, including introducing oneself, explaining role, using patient\'s preferred name, active listening, and appropriate use of touch, eye contact, etc. Maintains a safe environment for caregivers, patients and guests and documents care in compliance with policies and regulatory agencies. Supports the organization\'s vision, mission and values; champions Value Improvement Practice (VIP) and continuous improvement.
EDUCATION
Required:
Graduate of an accredited school of nursing. Preferred:
BSN
LICENSURE/CERTIFICATION/REGISTRATION
Required:
Current Oregon RN License. AHA Basic Life Support for Healthcare Provider certification. Preferred:
Certification in Case Management.
EXPERIENCE
Required:
3 years of clinical nursing experience in an acute care setting. Knowledge of Quality Improvement. Prior experience with disease management, patient and staff education. Preferred:
Experience in case management and/or discharge planning. Specialty areas such as cardiac, ED, oncology, orthopedics or neuroscience.
ADDITIONAL POSITION INFORMATION
Additional duties for RN, Case Manager, Emergency Department: screens, assesses, plans, and facilitates services for health care needs with quality and cost-effective outcomes. Identifies complex, high-utilization ED patients appropriate for case management; reviews ED patients to identify those suitable for case management screening and potential admission or referrals. Manages discharge planning for case management patients in ED, including placements, medications, and PCP assignment; identifies barriers and leads resolution. Provides referrals to community resources and educates patients/families about referrals; collaborates with physicians on medical necessity and level of care; notifies case management of admissions needing follow-up. Serves as a resource and provides education to physicians on inpatient and observation medical necessity criteria.
PERSONAL PROTECTIVE EQUIPMENT
Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.
PHYSICAL REQUIREMENTS
Patient Care Level 1: 75% continually speaking/hearing; 50% frequent sitting/keyboard use; 25% standing, walking, bending, stooping, lifting 1-10 pounds; grasping; driving; hearing; etc. Exposure to Elemental Factors: occasional chemical exposure; rare wet/slippery area; never heat, cold, etc. BBP Exposure: Risk for exposure to BBP.
ADDITIONAL DETAILS
Schedule: Weekly hours not specified; Caregiver Type: Relief; Shift: Variable; Exempt: No; Job Family: Case Manager; Schedule Days: As Scheduled; Shift Start/End: 8:00-16:30
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TITLE:
RN, Case Manager REPORTS TO POSITION:
Manager of Care Coordination DEPARTMENT:
Care Coordination DATE LAST REVIEWED:
December 9, 2021 OUR VISION:
Creating Americas healthiest community, together OUR MISSION:
In the spirit of love and compassion, better health, better care, better value OUR VALUES:
Accountability, Caring and Teamwork DEPARTMENTAL SUMMARY:
The Case Management Department at St. Charles Health System engages in a collaborative process that assesses, plans, implements, coordinates, monitors and evaluates the options and services required to meet the client\'s health and human service needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost- effective interventions and outcomes. The RN Case Manager provides clinically based case management to support the delivery of effective and efficient patient care. This position has accountability for utilization management and discharge planning for patients within the assigned caseload. The Case Manager collaborates with the health care team to identify appropriate utilization of resources. This position does not directly manage other caregivers.
ESSENTIAL FUNCTIONS AND DUTIES
Utilizes the nursing process (assessment, diagnosis, planning, intervention, evaluation) to assess the patient\'s condition and needs; set outcomes; implement nursing actions; and evaluate progress. Uses criteria to confirm medical necessity for continued stay; in coordination with the patient, family and health care team, creates a discharge plan. Collaborates with team members to facilitate patient and family learning; reinforces continued health care through teaching and/or referrals. Partners with physician, hospital administration, patient/family, peers, and other disciplines to implement and document the discharge plan; documents in the patient record per SCHC policies. Supports outcomes such as reduced length of stay, reduced cost per discharge, improved discharge procedures, patient satisfaction, and interdisciplinary communication; evaluates continued stay for appropriateness. Manages clinical aspects of discharge planning, including post-discharge needs, wound care, Rehab Center placement updates, medication procurement for initial 30 days, primary care physician assignment and complex discharge issues. Identifies barriers to discharge or transfer and leads resolution efforts; schedules and leads complex discharge rounds and conferences with patient, family and the team. Acts as patient care facilitator and liaison to internal services and external agencies. Provides staff education and participates in quality improvement activities related to case management. Provides cross-over coverage for other units/sites as needed. Supports a healing environment and intentional relationships to enhance the care experience. Delivers therapeutic presence and effective communication with patients, including introducing oneself, explaining role, using patient\'s preferred name, active listening, and appropriate use of touch, eye contact, etc. Maintains a safe environment for caregivers, patients and guests and documents care in compliance with policies and regulatory agencies. Supports the organization\'s vision, mission and values; champions Value Improvement Practice (VIP) and continuous improvement.
EDUCATION
Required:
Graduate of an accredited school of nursing. Preferred:
BSN
LICENSURE/CERTIFICATION/REGISTRATION
Required:
Current Oregon RN License. AHA Basic Life Support for Healthcare Provider certification. Preferred:
Certification in Case Management.
EXPERIENCE
Required:
3 years of clinical nursing experience in an acute care setting. Knowledge of Quality Improvement. Prior experience with disease management, patient and staff education. Preferred:
Experience in case management and/or discharge planning. Specialty areas such as cardiac, ED, oncology, orthopedics or neuroscience.
ADDITIONAL POSITION INFORMATION
Additional duties for RN, Case Manager, Emergency Department: screens, assesses, plans, and facilitates services for health care needs with quality and cost-effective outcomes. Identifies complex, high-utilization ED patients appropriate for case management; reviews ED patients to identify those suitable for case management screening and potential admission or referrals. Manages discharge planning for case management patients in ED, including placements, medications, and PCP assignment; identifies barriers and leads resolution. Provides referrals to community resources and educates patients/families about referrals; collaborates with physicians on medical necessity and level of care; notifies case management of admissions needing follow-up. Serves as a resource and provides education to physicians on inpatient and observation medical necessity criteria.
PERSONAL PROTECTIVE EQUIPMENT
Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.
PHYSICAL REQUIREMENTS
Patient Care Level 1: 75% continually speaking/hearing; 50% frequent sitting/keyboard use; 25% standing, walking, bending, stooping, lifting 1-10 pounds; grasping; driving; hearing; etc. Exposure to Elemental Factors: occasional chemical exposure; rare wet/slippery area; never heat, cold, etc. BBP Exposure: Risk for exposure to BBP.
ADDITIONAL DETAILS
Schedule: Weekly hours not specified; Caregiver Type: Relief; Shift: Variable; Exempt: No; Job Family: Case Manager; Schedule Days: As Scheduled; Shift Start/End: 8:00-16:30
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