Clinical Resource Manager

Summary

Provides hospital case management/utilization review and discharge planning collaboratively determining level of care needs beyond acute care, providing decision support to patients, families and physicians, managing patient and family expectations, and ensuring a smooth transition to the next level of care and services. Coordinates the integration of social services into patient care as appropriate. Coordinates the hospital activities concerned with case management/utilization review and discharge planning.

Adheres to departmental goals, objectives, standards of practice, and policies and procedures. Ensures quality patient care and adheres to regulatory compliance. Provides concurrent assistance and support to physicians and other clinical members of the health care team in coordinating the delivery of services for a select group of patients. To help achieve quality clinical and cost outcomes, incorporates real-time contacts with physicians, nursing, and ancillary caregivers to establish specific treatment, cost, and transition targets and to facilitate transition planning.

Part time

Day Shift

Part-time, Friday, Saturday and Sunday

Provides hospital case management/utilization review and discharge planning collaboratively determining level of care needs beyond acute care, providing decision support to patients, families and physicians, managing patient and family expectations, and ensuring a smooth transition to the next level of care and services. Coordinates the integration of social services into patient care as appropriate. Coordinates the hospital activities concerned with case management/utilization review and discharge planning.

Adheres to departmental goals, objectives, standards of practice, and policies and procedures. Ensures quality patient care and adheres to regulatory compliance. Provides concurrent assistance and support to physicians and other clinical members of the health care team in coordinating the delivery of services for a selected group of patients. To help achieve quality clinical and cost outcomes, incorporates real-time contacts with physicians, nursing, and ancillary caregivers to establish specific treatment, cost, and transition targets and to facilitate transition planning.

• Colleague must have an RN license, as defined by their primary work state (Idaho or Oregon).
• Idaho only:
  If a nurse moves to Idaho from another compact state, they must apply for licensure by endorsement and update their primary state of residence to Idaho within 60 days of being hired.
• All colleagues must provide licensure or proof of application for secondary state within 90 days of hire.
• BSN required. A master’s degree is preferred.
• A minimum of 2 years of varied hospital clinical experience is required.
• Experience in case management, home health, and/or the insurance industry preferred.

• Knows, understands, incorporates, and demonstrates the Organization's Mission, Vision, and Values in behaviors, practices, and decisions.
• Demonstrates knowledge and skills to competently care for all assigned age groups (Neonate, Child, Adolescent, Adult, Geriatric as applicable).
• Revenue Management: ensures the accuracy of documenting services and supplies provided to the patients.
• Coordinates the integration of social services and case management functions into patient care, discharge, and home planning processes with other hospital departments, external service organizations, agencies and healthcare facilities.
• Completes a screening/assessment of physician assigned cases to determine medical necessity/status determinations and transition needs. Reassesses, monitors, and modifies transition needs as appropriate.
• Conducts concurrent medical record review using established medical necessity criteria to determine correct level of care for acute patients. Assists physicians with completing transfer and discharge orders. Maintains knowledge of federal, state, and private agency review requirements and regulations.
• Provides education to all health care team members, including physicians,…