RN Case Manager - Omaha;

Case Management-Omaha

Full Time - Day

JOB DESCRIPTION
Job Title: RN Case Manager Job Code: 800010
Immediate Supervisor:
Senior Director Case Mgmt
- Hospital Programs Status:
Non-exempt
DEPARTMENT FUNCTION/JOB OVERVIEW
The Case Manager is responsible for the collaborative team process which assesses plans, implements, coordinates, monitors and evaluates the options and services to meet the patient’s health needs, using communication and available resources to promote quality, cost effective outcomes. These duties include the development of the patient’s overall plan of care including the identification, periodic review and revision, and communication of an individualized interdisciplinary plan of care.

The case manager is accountable for meeting quality patient outcomes and service delivery based on (1) appropriate length of stay, (2) effective utilization of resources including program utilization, (3) continuity through a continuum of care, and (4) established standards. Additional responsibilities include serving as a liaison between patient, family, payer, team and physician; facilitation of education and training for patients, families and caregivers;

for overall coordination of the patient’s program. The case manager must adhere to the CARF standards for a case manager. Work will be performed in an ethical and legal manner following organizational policies, processes, protocols and procedures. Responsible for quality service delivery and internal/external customer relations for Madonna as a whole, including upholding the mission and values for the department and facility.

• Analyze patients past and current status; assess impairments, disabilities and handicaps in order to plan, coordinate, implement and monitor an effective and efficient plan of care.
• Analyze and monitor patient’s need for specialized tests, equipment, transportation, etc., in order to coordinate the provision of and payment for such services.
• Monitor the patient’s current status as well as information in the medical record, and assimilate/compare to professional nursing knowledge of disease, trauma or disability to evaluate and ensure the appropriate provision of care.
• Analyze, assess and monitor the principal diagnosis, secondary diagnoses, and procedures assigned to the patient to evaluate and ensure accurate reimbursement in hospital programs.
• Analyze, assess and monitor the Patient Based Income Statement (PBIS) to obtain CMG or DRG length of stay to assist in the management of the patient’s length of stay and manage patients’ financial information in order to maximize appropriate utilization of resources.
• Compile, coordinate and analyze patient’s program information in accordance with the requirements of third party payers in order to maximize appropriate utilization of patient’s financial benefits.
• Coordinate and compile information regarding patient’s status and outcomes, unplanned discharges and patient follow up to assess customer satisfaction, facilitate problem resolution, and contribute to evaluation of the program.
• Compile and analyze information to monitor patient’s response to the current treatment plan, assess available, clinically and financially appropriate alternatives in order to plan and implement appropriate placement in the continuum of care.
• Compile and analyze patient, program and facility clinical and financial data in order to evaluate and improve patient outcomes, and maintain program viability.
• Coordinate and compile patient information in order to ensure that discharge arrangements are completed and facilitate the implementation of discharge recommendations, ensuring documentation meets all regulatory requirements
• Mentor, instruct and communicate with patients and patient…