ED​/MH Nurse Case Manager

Overview

POSITION SUMMARY

The Nurse Case Manager, Emergency Department (ED) is responsible for establishing, coordinating, and maintaining the process to increase patient throughput to the most appropriate level of care while facilitating interdisciplinary care across the continuum for the ED. The Nurse Case Manager collaborates with the patient/family, multidisciplinary team, physicians, community resources and payers to ensure the patient’s progress and level of care is appropriately determined for the emergency episode of care and for the inpatient encounter to ensure that care is performed and facilitated in an efficient and cost-effective manner.

The Nurse Case Manager has well developed knowledge and skills in patient status determination (i.e. Inter Qual Criteria), in the assessment and care management of patients and families within the ED, inpatient and outpatient settings. The scope of practice includes patient/family assessment and management, resource management, identifying patients appropriate for Inpatient Admission, Observation, or Outpatient status, care facilitation, discharge planning with referral to all levels of care, and other related duties specific to the defined patient population.

This Nurse Case Manager collaborates with other case managers, social work staff, the Access Center, Admissions, the Outcome Manager, and other physician and administrative leadership staff within the ED, the Coordinated Care Department and both the inpatient and outpatient settings. She/he uses knowledge of pathophysiology, pharmacology, and clinical care processes to participate with other clinical staff and physicians in the development of clinical practice guidelines and physician order sets for the purpose of improving quality of care, changing practice, and reducing costs.

The role has a primary reporting relationship to the Director of Coordinated Care.

The ED/MH Nurse Case Manager works with an interdisciplinary team to assess care plans, monitor progress, and make recommendations to ensure safe and efficient hospitalizations. Responsible for evaluating patients in the ED for medical necessity and care coordination needs. Assesses potential admissions and works with advanced practice clinicians/physicians to determine appropriate admission status. Proposes and implements outpatient plans for safe discharge from the ED with physician approval.

Coordinates care for patients with abuse, chronic pain, and frequent utilization issues. Interacts with patients or customers of all ages, from newborn to geriatric.

As part of this role, they will also interact with individuals who have mental health issues to help them access and navigate the resources they need to improve their well-being. with individuals who have mental health issues to help them access and navigate the resources they need to improve their well-being.

NECESSARY QUALIFICATIONS

Education:

MSW Social Worker:
Master’s Degree in Social Work (MSW)

RN Case Manager:
Associate’s degree in nursing

License/Certification:

MSW Social Worker:
Licensed Master Social Worker (LMSW)

RN Case Manager: A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States;
Must have and maintain current Basic Life Support (BLS) certification by the American Heart Association throughout employment

Experience:

• Minimum of (2) two years of current care/case management experience in the Emergency Department
• Two (2) years of patient care experience (Hospital, Home health, Skilled Nursing)
• Proficient with Electronic Medical Records, Outlook, Microsoft Office Word, and Excel.
• Experience and knowledge of discharge planning, case management, or utilization review processes.

Other

Skills and Abilities

:

A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas:

• Positive working relationships with others
• Possession of high ethical…