Registered Nurse Case Manager Lead; RN

Position: Registered Nurse Case Manager Lead (RN)
Overview

Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the opportunity to make a meaningful impact in patients' lives while enjoying a supportive work environment that fosters professional growth and work-life balance. Ready to be a vital part of our mission? Apply today and bring your passion for nursing to a place where it truly matters!

At Abrazo Central Hospital, we understand that our greatest asset is our dedicated team of professionals. That's why we offer more than a job - we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:

* Medical, dental, vision, and life insurance

* 401(k) retirement savings plan with employer match

* Generous paid time off

* Career development and continuing education opportunities

* Health savings accounts, healthcare & dependent flexible spending accounts

* Employee Assistance program, Employee discount program

* Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance

Note:

Eligibility for benefits may vary by location and is determined by employment status

Job Summary

Position Summary

The position manages the continuum of care for assigned patients and serves as the content expert and role model for department staff. The Lead Case Manager serves as the expert in all aspects of the role including care coordination, collaboration and facilitation, advocacy for patients and families, discharge planning and utilization review. The position serves as the department expert aka 'Super User' of MIDAS, CERMe, Curaspan, Portal and MS4.

The Lead Case Manager has the primary responsibility for training new staff and providing education to all department staff when new initiatives are implemented. The position provides initial and annual Inter Qual training for RN Case Managers.

Responsibilities

* Discharge Planning - Utilize the nursing process to conduct a thorough assessment of discharge needs beginning at admission and as care needs evolve to assure a seamless and safe patient transition to the most appropriate level of care that has the identified resources to meet the medical, nursing and psychosocial needs of the patient. The RN Case Manager works with the physician who is the decisive authority in the referral, transfer or discharge of his/her patient to another level of care.

The RN Case Manager collaborates with the interdisciplinary team to implement the identified discharge plan.

Accountability / Responsibility:

* Develops and effectively utilizes a network of information regarding community resources

* Coordinates the discharge planning process in collaboration with social workers and/or other professional members of the interdisciplinary team.

* Appropriately delegates within the scope of practice discharge planning activities / functions and supervises others involved with discharge planning including LPNs, Case Management Coordinators or other non-licensed personnel performing discharge planning activities.

* Identifies the appropriate post hospitalization care and services required.

* Develops post hospital plan of care with the patient and / or family, physician and external resources.

* Communicates and documents discharge planning needs.

* Initiates appropriate and timely social services, palliative care or other specialty referrals.

* Provides necessary patient teaching relevant to discharge needs, post hospital care arrangements prior to discharge.

* Assesses the patient prior to discharge to determine if the plan is appropriate and makes necessary revisions.

* Keeps the interdisciplinary care team informed re: details of the discharge plan including printing updated Midas notes and placing on chart.

* Communicates essential information to the next care provider as described in the hospital discharge planning policy.

* Educates patient regarding their Medicare appeal rights and initiates the Detailed Notice of Discharge (DND) when the patient decides to appeal their discharge.

* Contacts the Quality Improvement Organization (QIO) per established protocol detailed in the Hospital Issued Notice of Non-Coverate (HINN).

* Utilization Review. Consistently applies the utilization review process as required by the Code of Federal Regulations including the use of Abrazo designated criteria for primary review. Incorporates into the utilization review process the ability to access and interpret clinical information against the designated review criteria to reach correct admission status determinations. Has the current knowledge of applicable regulations and laws pertaining to the major payers including Medicare, Medicaid, and other payers.

Works with the interdisciplinary team to ensure that the care and services provided are medically necessary, cost effective, delivered efficiently and timely, and at the appropriate level of…