Registered Nurse - Post Acute Network Skilled Nursing Facility Program Manager IL

Responsibilities

• Serve as the liaison between the hospital and the post acute network (PAN) skilled nursing facilities. Manage and facilitate communication between inpatient care managers, external care providers, and outpatient care managers for high-risk patients transitioning in and out of the acute care setting and post acute programs. Assist the transition of high-risk patients to post acute programs and back to their primary care physician (PCP) and community.
• Monitor, collect and analyze data to evaluate the effectiveness, safety and quality of patient care in the post acute care network programs.
• Address questions and concerns from providers, patients and families regarding post acute programs in coordination with other care teams. Act as a conduit for problem solving, resolution and service recovery.
• Ensure accurate placement of patients into the Post Acute Network program based on established criteria. Provide for Utilization Review for populations that need additional oversight.
• Interact with hospital administrative teams and leaders, PHO Directors, Director of Case Management, Home Care Directors, Hospice Directors, Care Managers, Social Workers, Medical Directors, Physicians, APNs and Nurses. Facilitate communication with post acute providers at skilled sites (Nursing Home Administrators, Directors, Admissions staff, social services staff, nurses, physicians, SNFists, and Advance Practice Nurses). Engage with patients and families regarding post acute program options when service recovery and/or quality issues arise.
• Monitor which post acute program is appropriate for patients, solve problems for unique situations, and determine best methods of data collection and transfer of information across sites. Coach Sub-Acute Skilled Nursing Facility providers to shorten length of stay when appropriate, reduce readmissions and increase utilization of Advocate Aurora providers. Evaluate utilization of resources, review sentinel events and follow up on quality issues.
• Address issues of non-compliance with staff and MDs regarding referrals to appropriate programs. Identify serious quality issues or trends related to post acute providers and recommend policies and procedures to enhance service delivery.
• Manage relationships within the assigned territory and oversee their hospital, clinics and skilled nursing facilities. Coordinate with other Post Acute providers such as physician offices, Home Health Providers and Assisted Living providers. Travel to meetings regularly with Skilled Nursing Facility staff.
• Provide support to the clinical team at the facility, removing operational barriers that enable the team to function at the top of their license and focus on medical management of their patient panel.
• Uphold and adhere to the organization s Code of Ethical Conduct, ensuring personal actions and actions of supervised employees comply with applicable policies, regulations and laws.

• Nurse, Registered (RN)

• Bachelor s Degree in Nursing. Typically requires 5 years of experience in healthcare, including an acute setting, and 1 year of case management and quality improvement experience.

• Understanding of hospital and physician operations and post acute services affected by managed care and health care reform. Thorough understanding of Medicare, Medicaid, Medicare Advantage and private insurance.
• Strong verbal and written communication skills and excellent interpersonal abilities to interact with internal and external clients. Demonstrated ability to work well with physicians and other professionals. Detail-oriented with excellent organizational skills.
• Proficiency in Microsoft Office (Excel, Word, PowerPoint, Access) or similar products. Ability to analyze data, think strategically and act tactically for results. Ability to handle difficult situations, conflicts and maintain professionalism. Ability to work autonomously with minimal direction. Strong social skills and relationship-building. Creative problem solving and facilitation skills. Self-motivated.
• Registered Nurse license issued by the state of practice.

• Must sit, stand, speak, read/write, and walk throughout the workday. Travel required to area skilled nursing facilities and hospitals; may travel outside of assigned territory. Local travel to meet with stakeholders, physicians and referral sources. Must provide own vehicle for travel. Generally exposed to a normal office environment. Occasional lifting up to 20 lbs. Early and late meetings as needed to establish contact with stakeholders.