RN - Integrated Case Manager - PRN

RN
- Integrated Case Manager - PRN

Olathe Hospital

The Integrated Nursing Case Manager, under the direction of the Director/Manager of Case Management, provides care and service safely and efficiently for a full range of services to patients of all ages and their families. The primary role is to collaborate, communicate, and facilitate coordination of services during hospitalization and post‑hospitalization as established by the healthcare team. The Integrated Nursing Case Manager concurrently facilitates proactive patient care services to ensure that care is appropriate, timely, and cost‑effective and achieves the desired outcome.

The Integrated Nursing Case Manager coordinates the care and service of selected patient populations across the continuum of illness; promotes effective utilization and monitoring of health care resources; and guides all disciplines toward positive quality outcomes.

• Accepts responsibility and accountability for achievement of optimal outcomes within their scope of practice. Follows policies, procedures and standards; complies with Corporate Compliance program. Assumes responsibility for risk and safety issues associated with the position. Takes call as required by the department expectations. Performs specific job responsibilities and demonstrates accountability for own actions and decisions.
• Acquires and maintains knowledge and competence related to the expectations of their position and practices within their scope. Brings ideas and concerns to supervisor, participates in department decision making. Maintains current licensure.
• Advocates on behalf of patients and caregivers for identification and access to services. Advocates for the protection of the patient’s health, safety and rights. Ensures patient choice and consistently supports a patient centered environment.
• Identifies and manages other patient needs, making referrals to the appropriate personnel; validates the need was addressed.
• Identifies patient educational, social and financial needs; referring to the appropriate personnel.
• Spiritual support. Refers to Pastoral Care or their pastor.
• Assures prudent utilization of all resources (fiscal, staff resources, environmental, equipment and services) by evaluating the options available. Demonstrates ability to balance cost and quality to assure the optimal clinical and financial outcomes. Participates in performance improvement activities.
• Reviews all assigned Outpatient Observation patients and verifies correct status assignment and develops discharge plan.
• Conducts admission and continued stay reviews to evaluate medical necessity of admission/continued stay and appropriateness of treatment plan using screening criteria and benchmark tools as defined by the department. When appropriate confers with the attending physician, department management, physician advisor, and insurance companies to assure the justification of admission/continued stay.
• Facilitates external payer certification for hospital and discharge needs.
• Initiates the process to move the patient appropriately through the continuum of care.
• Minimizes and informs patients of their financial responsibilities.
• Ensures compliance with payer rules and regulations.
• Monitors, records, and reports all variances related to utilization of resources.
• Communicates timely, relevant and accurate information to all parties involved with patient’s care. Communicates effectively and frequently within the multidisciplinary team and patient/family throughout the hospitalization.
• Facilitates the progression of care by advancing the care plan to achieve desired outcomes. Monitors the patient’s progression towards the desired outcome. Facilitates discharge planning, resource referral and patient education.
• Uses critical thinking skills to facilitate proactive discharge planning, initial discharge assessment on assigned patient population, establish daily goals, validate medical record documentation of the patient’s clinical picture all as it relates to the case management process.
• Identifies discharge needs such as equipment, home health services, nursing…