RN Case Manager P/T days with Benefits
Company: Hackensack Meridian Health
Posted on: September 17, 2020
Description: The Nurse Care manager is a member of the
healthcare team and is responsible for coordinating, communicating
and facilitating the clinical progression of the patient's
treatment and discharge plan .He/She is accountable for a
designated patient caseload. They asses, plan, and facilitate, with
patients/families and healthcare professionals involved in the
patients care to meet treatment goals, expected length of stay, and
arrange for the appropriate next level of care .Oversees Inter
facility Coordination and handoff between acute & post-acute
services.Responsibilties: 1. All patients who are admitted for
medical care are screened for potential discharge needs regardless
of race, age, sex, religion, diagnosis and ability to pay. All
patients that are determined to need discharge planning or any
patient that requests discharge planning services will be assessed.
2. Meets directly with patient/family to assess needs and develop
an individualized plan in collaboration with the physician and
other members of the health care team. 3. Facilitates communication
and coordination between members of the health care team and
involves the patient/family in the decision making process, in
order to minimize fragmentation of services, manage resources and
remove barriers to the plan of care. 4. Develops a discharge plan,
in collaboration with the patient/family, patient caregiver,
patient support persons and healthcare team that will provide
maximum benefit for each patient. Ensures the discharge plan will
be the least restrictive environment that best meets the continuing
care needs of the patient. Ensures provisions of continued care at
home or in an appropriate extended care facility based upon the
patient needs. Confirms the patient has a primary care provider
upon discharge or refers appropriately to an ACO or FQHC. 5.
Participates/Leads Multidisciplinary Team Rounds, specific to
assigned unit. Brings forth issues which impact on discharge as
well as LOS to the team, in a timely manner, for discussion and
resolution. 6. Works collaboratively with all members of the
multidisciplinary health care team and external teams to effect
timely and appropriate transitions to the next appropriate level of
care. 7. Maintains current and up to date information of community
resources and refers patients to those community resources which
will enhance patient's life. Consults with other community agencies
and committees to identify potential resources to support patients
and their families. 8. Documents and communicates information to
the Multidisciplinary Team in order to coordinate and maximize
care. The EMR reflects the education, coordination of home care
services, and placement in an extended care facility, durable
medical equipment, and referral to complex care management team,
ACO navigators and authorizations from providers. 9. Provides
patients and families with resources and discharge options.
Educates about risks and benefits of discharge options. Educates
patients/families on how to obtain services, available health care
benefits, and Provides Second Important message is provided to
Medicare patients 4 to 48 hours prior to discharge. 10.
Participates actively on appropriate committees, workgroups, and/or
meetings. Is a positive problem solver. Identifies and refers
quality issues for review to the Quality Management Program. 11.
Reassesses periodically and evaluates against care goals and the
plan of care and, when indicated, the plan or goals are revised.
Medical records reflect that each patient's discharge plan is
re-assessed at a minimum of weekly and in response to change in
patient status. 12. Collaborates with social work to support the
following functions; crisis intervention, counseling support and
referrals, abuse/neglect, adoption, guardianship and psychosocial
assessment. 13. Completes all other necessary duties with attention
to detail and in a timely manner. 14. Collaborates with Utilization
Review Nurses. 15. Provides Important Message, ABN, Observation
letter as required. 16. Referrals: a. Acute Rehabilitation
Facilities b. Sub-Acute Facilities c. Assisted Living Facilities d.
Adult Day Program e. Level 1 / PAS/PASARR f. EARCH PAS g. Home Care
h. Hospice at Home/Facility I. DME Equipment j. Ambulance
Transportation k. Financial Assessment l. North Hudson Clinics m.
Medication Indigent Programs n. Community Linkage o. End of Life
Issues p. Boarding Home Placement 17. Provides cross coverage for
UR and Discharge Planning.Qualifications: Education, Knowledge,
Skills and Abilities Required: 1. Bachelor's degree in nursing
(BSN) or 1 year experience for non BSN HackensackUMC employees. 2.
Knowledge of federal and state regulations (DOH, Medicaid/Medicare)
3. Knowledge of third party payers and/or managed care principles.
4. Knowledge of guidelines for Medicaid/Medicare and related state
programs. 5. Knowledge of InterQual/MCG criteria and other
guidelines for medical necessity, setting and level of care, and
concurrent patient management. 6. Knowledge of health care delivery
system, utilization and review and case review procedures. 7. Good
working knowledge of benefit plans; HMO, Medicare, Medicaid,
Employee, Commercial, Medicare Advantage, etc. 8. Computer skills
to include Microsoft Work, Excel, data entry and Utilization
Management Software. 9. Strong organizational and problem solving
skills. 10. Excellent oral and written communication and
interpersonal skills. 11. Exceptional communication skills to
enable communication and collaboration with physician, patients,
families and ancillary staff. 12. Excellent critical thinking
skills. 13. Ability to work in a fast pace team environment. 14.
Ability to prioritize and multi-task. 15.Ability to make sound,
independent clinical judgements and act professionally under
pressure. Education, Knowledge, Skills and Abilities Preferred: 1.
Three to five years clinical experience. 2. Experience with
relevant systems; Excel, Word, EPIC, Allscripts, MCG, Sorian
Licenses and Certifications Required: 1. NJ State Professional
Registered Nurse License. 2. AHA Basic Health Care Life Support HCP
Certification. Licenses and Certifications Preferred: 1. Certified
Keywords: Hackensack Meridian Health, Hackensack , RN Case Manager P/T days with Benefits, Healthcare , Hackensack, New Jersey
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