Under supportive supervision, the Case Management Nurse supports the physician and interdisciplinary team in the provision of patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers. The role integrates and coordinates utilization management, care facilitation, transitions of care, and discharge planning functions. The Case Management Nurse is accountable for a designated patient caseload and plans effectively in order to meet patient needs, manage the length of stay, and promote efficient utilization of resources.
Core Competencies
Adheres to policies, procedures, and standards of practice to deliver safe and optimal care
Complies with Joint Commission’s national patient safety goals
Complies with organizational quality dashboard/benchmarking goals
Maintains regulatory compliance consistent with quality standards and ethical obligations of the profession
Participates in activities in alignment with the Magnet Model
Participates in organizational committees, task forces and/or projects including presentation of project reports, committee recommendations, and task force activities at the unit level.
Participates in Peer Review
Participates in professional development activities
Provides patient and family education throughout the care of patient
Performs as a preceptor in an active and engaged manner
Provides age specific and culturally competent discharge planning to all patients.
Utilizes resources in an economical manner
Department Specific Competencies
Manages all aspects of discharge planning for assigned patients as follows: Meets directly with patient/family to assess needs and develop an individualized continuing care plan in collaboration with the physician.
Determines appropriate post-hospitalization facilities (home versus supervised living situation, board and care facility, extended –care facility, or rehabilitation facility), durable medical equipment, post-discharge nursing and/or therapist interventions, social service involvement, and need for assistance with activities of daily living.
Interviews patients, family members and/or care givers, interface with responsible physicians, and reviews medical records.
Identifies and resolves delays and obstacles in collaboration with the RN Case Managers, nursing and the attending physicians
Attends interdisciplinary conferences/team meetings where appropriate to discuss patient’s home situation, level of independence and activities of daily living, home management and environment, and anticipated discharge needs for continuum of care.
Develops and maintains cooperative relationships with hospital personnel, physicians, suppliers and insurance case managers.
Enters data including referral for managed care patients, into Home Health System.
Monitors activity of observation cases to see that the patient is appropriately discharged in a timely manner.
Education
Degree
Program
Associates
Nursing
Additional Information
Experience
Number of Years Experience
Type of Experience
1
Acute Case management
5
Nursing Clinical experience
Additional Information
N/A
License / Certification Requirements
Registered Nurse License
BCLS or ACLS Certification
Compensation Range:
$70.62 / Hour
Numbers & Facts
Location
Torrance, California
Website
https://www.torrancememorial.org/contact-us/
Skills
Activities of Daily Living (ADLs)unmatched
Benchmarkingunmatched
Case Managementunmatched
Certified Case Manager (CCM)unmatched
Clinical Outcomesunmatched
Community and Social Servicesunmatched
Conferencesunmatched
Cost Controlunmatched
Data Entryunmatched
Discharge Plansunmatched
Durable Medical Equipmentunmatched
Employee Relationsunmatched
Health Planunmatched
Healthcare Qualityunmatched
Home Careunmatched
Hospitalunmatched
Insuranceunmatched
Maintain Complianceunmatched
Managed Careunmatched
Medical Recordsunmatched
Needs Assessmentunmatched
Nursingunmatched
Patient Careunmatched
Patient Educationunmatched
Patient Safetyunmatched
Quality Metricsunmatched
Registered Nurse (RN)unmatched
Regulatory Complianceunmatched
Reporting Dashboardsunmatched
Resource Utilizationunmatched
Time Managementunmatched
Utilization Managementunmatched
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