Under supportive supervision, the Case Management Nurse I position 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, transitions of care, and discharge planning functions. The Level I RN Case Manager is accountable f... more details
Description
Under supportive supervision, the Case Management Nurse I position 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, transitions of care, and discharge planning functions. The Level I RN Case Manager is accountable for a designated patient caseload and plans effectively in order to ensure patients receive the right care in the most appropriate setting, 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
Performs as a preceptor in an active and engaged manner
Provides patient and family education throughout the care of patient
Provides age specific and culturally competent discharge planning to all patients.
Utilizes resources in an economical manner
Department Specific Competencies
Assesses, analyzes, synthesizes data gathered and develops an initial discharge plan.
Collaborates/communicates with the multidisciplinary care team throughout the continuum of care.
Ensures appropriate utilization management by analyzing and synthesizing clinical documentation, and collaborating with the multidisciplinary team to ensure patients are receiving the right care, in the right place at the most appropriate level of care.
Establishes the patient/family/case manager relationship and determines their readiness to engage in the discharge planning process.
Maintains a working relationship with ancillary departments, external case managers and post-acute care providers.
Screens / identifies patients that may benefit from professional case management services.
Uses critical thinking to formulate and carry out a discharge plan according to the patient’s needs.
Utilizes the Electronic Health Record to ensure timely, accurate and complete documentation of assessments, referrals, and variances in care.
Education
Degree
Program
Associates
Nursing
Experience
Number of Years Experience
Type of Experience
1
Recent Acute Case Management experience
5
Nursing Clinical experience
Additional Information
or 1+ year(s) of comparable experience (such as a clinical liaison, clinical navigator)
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