RN Case Manager

RN Case Manager

US-OR-Portland

Requisition :

Position Category: Nursing-Care Management

Job Type: ONA union represented

Position Type: Regular Part-Time

Posting Department: Care Management

Posting Salary Range: $52.11-$86.81 per hour, based on RN Degree and level of experience

Posting FTE: 0.70

Posting

Schedule:

Monday - Friday with rotating weekends and holidays

Posting

Hours:

HR Mission: Healthcare

Drug Testable: Yes

The Care Management department provides several major services to assure safe and efficient through‑put of patients during their acute hospitalization and transition to the next level of care. Our goal is to balance individual clinical and psychosocial patient/family needs with the efficient and cost‑effective utilization of resources while promoting quality outcomes. RN case managers assess patients on admission for available family support, insurance resources, and potential discharge planning needs.

They engage in daily multidisciplinary rounds Monday through Friday to develop and implement patient discharge plans with input from various other disciplines. The RN case manager is responsible for coordinating post‑acute and discharge needs in a timely and cost‑efficient manner. Using established criteria to determine appropriateness of continued hospital stay, RN case managers work with payors on obtaining needed authorizations for ongoing hospitalization and/or identified post‑acute needs.

The RN Case Manager collaborates with the patient and family, members of the multidisciplinary team, community resources and agencies, and payors to ensure the patient’s progress and level of care is appropriately determined. Intensity of service is dependent on individual patient needs as assessed by the case manager. RN case managers practice robust utilization and resource management. RN case managers also frequently lead multidisciplinary and family care conferences involving complex care situations.

They contribute to meeting OHSU’s strategic plan of safe length of stay reduction and reduction in readmission rates. Case Management is represented on every adult and pediatric unit and in the Emergency department. Each Case Manager has an office with a workstation near the unit they are assigned to. Communication factors:
Case Managers are available by pagers, telephone/voicemail, Microsoft Teams, Epic Secure Chat, and e‑mail.

Case Management is represented on every adult and pediatric unit and the Emergency department. Communication factors:
Case Managers are available 7 days a week between the hours of . They are available by pager, telephone, e‑mail, and approved messaging applications.

• Assuring accurate patient status and admission order for pts entering via ED, and OR, 7 days per week; reviews ED Observation unit patients for meeting observation criteria and completes UR using established criteria; round with NP in ED OBs by 10am; effectivley communicates reviews with Patient Placement Office; follows up in collaboration with unit CM on admission status and completeness of Utilization review on admission;
  
  performs discharge planning for patients in the Emergency department; assesses patients potential to DC from ED with community care coordination (PCP location, follow up appointments, medication assistance, SNF, long term care, DME, Memory or Foster care); back up for weekend/EVE Case Managers; follows current data tracking procedures; reviews transfer center patients and advise physicians on acceptance of potential transfers; preforms Utilization Review for each patient admitted without a review during weekend hours using established medical necessity guidelines;
  
  reviews order/classification discrepancies and takes actions to resolve the discrepancy; discusses cases with providers and Case Managers as needed, including attending physicians and escalation to the Care Management Physician Advisor when indicated; assesses for and tracks potentially avoidable hospital days; educates providers regarding documentation requirements that support medical necessity determinations; delivers Condition Code 44 notices, Observation…