Job Title: Case Manager RN
Profession: Registered Nurse
Specialty: Case Management
Duration: 13 Weeks
Shift: Day
Hours per Shift: 8
Experience: 5+ Years of RN Case Management Experience
License: CA RN License
Certifications: BLS
Must-Have: Inpatient Acute Case Management Experience
Description:
Must have discharge planning experience.
Case Manager RN needed for 5/8s every other weekend.
Responsible for care coordination and care transitions planning throughout the acute care patient experience.
This position works in collaboration with the physician, utilization manager, medical social worker, and bedside RN.
Assures the timely progression and transition of patients to the appropriate level of care to prevent unnecessary admissions or readmissions.
The care management process encompasses communication and facilitates care across the continuum through effective resource coordination.
Goals of this role include achieving optimal health, access to care, and appropriate utilization of resources.
Collaboration occurs with patients, families, physicians, the interdisciplinary team, nursing management, quality, ancillary services, third-party payers, and community resources.
If assigned to the Emergency Department, the care management process addresses complex clinical and social situations efficiently to avoid unnecessary admissions.
Job Accountabilities:
Conduct patient initial and continued assessments.
Review initial physician admission care plan.
Gather additional medical, psychosocial, and financial information from patient/family interviews and medical records.
Determine moderate or high-risk levels for readmission.
Conduct screenings for ancillary supportive services.
Lead the healthcare team in developing comprehensive, cost-effective care coordination plans.
Identify and refer quality and risk management concerns for patient safety reporting.
Direct and oversee the case management assistants to determine preferences for post-acute care services.
Utilization Management:
Review medical records to ensure patients continue to meet level of care (LOC) requirements.
Work with attending physicians to confirm necessary documentation to support LOC.
Expedite transition planning for patients who no longer require acute level of care.
Monitor length of stay (LOS) and outliers requiring additional resources.
Collaborate with financial counselors for delivery of inpatient stay denials.
Ensure delivery of necessary patient information within required timelines.
Participate in patient rounds and collaborate with the interdisciplinary team for timely transitions.
Care Coordination/Care Transitions:
Formulate transition plans after reviewing appropriate care options.
Communicate assessment findings to the healthcare team.
Screen for 30-day readmissions and review previous hospital records.
Proactively identify barriers to care progression and work with the multidisciplinary team to resolve them.
Review and modify plans of care as necessary.
Assess the need for follow-up appointments and communicate them to patients/families before transitions.
Ensure necessary paperwork for post-acute transfers complies with regulatory requirements.
Identify patients with complex psychosocial issues and refer to the healthcare team.
Communicate with financial counselors regarding uninsured and underinsured patients.
Actively participate in ongoing department operations.
Identify new systems, processes, and protocols to improve practices.
Contribute to creating cost-effective practices that ensure the best patient/provider experience.
Communicate effectively with care management colleagues for safe transitions.
Manage all communications related to department operations.
Use effective interpersonal and communication skills to promote customer service.
Develop and maintain positive professional relationships with the healthcare team and community agencies.
Approach all customers with respect regardless of diverse backgrounds.
Participate actively in department operations and accept constructive feedback.
Utilize effective communication skills with colleagues to resolve issues in a timely manner.
Numbers & Facts
Location
Oakland, CA
Industry
Healthcare Services
Salary
$3,079
Company Size
1,000 to 1,499 employees
Website
https://cynethealth.com/
About Company
Cynet Health is a TJC certified MBE and one of the fastest-growing healthcare staffing firms in the US providing Health Med and Health IT staffing and consulting services to countless hospitals, SNFs, clinics, labs, CROs, health & wellness centers, pharmacies, and other medical facilities across the United States. Headquartered in Sterling, Virginia, we are a certified Minority-Owned Business Enterprise and a recognized Diversity Supplier.
Skills
Acute Careunmatched
Basic Life Support (BLS)unmatched
Case Managementunmatched
Certified Case Manager (CCM)unmatched
Communication Skillsunmatched
Cross-Functionalunmatched
Customer Support/Serviceunmatched
Discharge Plansunmatched
Diversityunmatched
Emergency Careunmatched
Financial Planningunmatched
Health Planunmatched
Healthcareunmatched
Hospitalunmatched
Interpersonal Skillsunmatched
Medical Recordsunmatched
Nursing Managementunmatched
Options Analysisunmatched
Patient Assessmentunmatched
Patient Careunmatched
Patient Care Denialsunmatched
Patient Safetyunmatched
Problem Solving Skillsunmatched
Quality Managementunmatched
Quality of Careunmatched
Registered Nurse (RN)unmatched
Regulatory Requirementsunmatched
Resource Utilizationunmatched
Riskunmatched
Risk Managementunmatched
Social Workunmatched
Support Documentationunmatched
Team Lead/Managerunmatched
Team Playerunmatched
Third-Party Payerunmatched
Time Managementunmatched
Utilization Managementunmatched
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