Case Manager - 4 West

Case Manager - 4 West
Job Description
Case Managers coordinate systems/services for patients through a multi-disciplinary team approach as well as review admissions/concurrent stays for intensity of service and severity of illness and relay information as requested to the payer sources. Case Managers assure the highest quality, most cost effective patient care in the most appropriate setting. Identifies the patient's needs before discharge and makes the needed arrangements to safely transition the patient through the continuum of care.
Department: 4 West
Hours: Monday-Friday, 8am-4:30pm
Requirement: Registered Nurse
Pay based on applicable experience; starting at $30.56
Responsibilities
Acts as an advocate for patient and significant others and facilitates patient and family/significant other's involvement in all care and discharge decisions. Asks every inpatient if they have a caregiver that will be assisting them at discharge. Chart their response, and if they choose a caregiver, coordinate care with the caregiver as close to discharge as possible and document this., Acts as an advocate for patient and significant others and facilitates patient and family/significant other's involvement in all care and discharge decisions. Asks every inpatient if they have a caregiver that will be assisting them at discharge. Chart their response, and if they choose a caregiver, coordinate care with the caregiver as close to discharge as possible and document this., Assesses and interviews high risk patients to coordinate care according to discharge policy. Assessment will be documented in the electronic medical record., Assessment - Collects pertinent data and information relative to the patient's health or the situation. Recognizes normal and abnormal findings when gathering data., Assists 3W staff with involuntary admissions, getting appropriate paperwork to the courier, getting Physician paperwork for court, and attending court if 3W staff unavailable., Assumes responsibility for remaining current on all regulatory and reimbursement rules and regulations., Assumes responsibility for remaining current on all regulatory and reimbursement rules and regulations., Checks to make sure that Medicare Rights Letter is signed upon admission to inpatient bed status and if known discharge get letter signed before discharge per policy. Checks to make sure that the Observation Letter is signed upon admission if patient is in observation bed status., Collaborates with area Long Term Care Facilities and Group Homes through daily communication M-F on their residents., Completes Readmission Risk Assessment on patients with diagnosis of CHF, COPD, or Pneumonia if the Care Coordination Team did not complete it in the Emergency Department., Coordinates Medicare appeals with the Director of Case Management and the QIO., Coordination of Care - Plans and evaluates care in collaboration with appropriate disciplines., Counsels patients as needed regarding third party benefits including but not limited to patient obligations, co-pays and other applicable requirements that help assure the best informed discharge decision outcomes. , Delivers termination of benefits letters to patients as determined by third party payers, assuring patient understanding and awareness of rights and obligations. Assures understanding by family/significant others when patient is unable to understand/comprehend. , Develops a specific intervention plan for needs identified by the care team members. Collaborates with Social Worker as needed. Assesses each new patient for potential needs early in the admission based on health history completed by nursing. Case Managers will defer cases to social worker as appropriate., Diagnosis - Analyzes assessment data to determine actual or potential diagnosis, problems, issues., Establishes and maintains effective communication with physicians, nurses, and all other members of the health care team to facilitate and promote the goals & objectives for each individual patient's needs/plan of care. , Evaluation - Evaluates progress toward attainment of goals and outcomes. Reports data and outcomes to others as appropriate., Identifies patients that meet palliative care and General Inpatient Hospice needs., Implementation - Implements care or work plan in alignment with the plan and approved safety, infection control,and department/organization standards., Knowledge - In collaboration with leaders, actively pursues required knowledge and skills through orientation activities specific to the position, reading current literature and seeking new learning opportunities., Outcomes Identification - Identifies expected outcomes for a plan individualized to the patient or situations., Participates in multidisciplinary rounds Monday thru Friday. , Planning - Develops a plan that prescribes strategies to attain expected, measurable outcomes., Relationships - Establishes effective working relationships with peers, physicians, and other members of the health care / work team. Identifies and confers with appropriate resources regarding patient / work decisions. {+ 5 more}
Requirements:
ADN (Required)
BLS or CPR certification within 90 days of hire. - Sarah Bush Lincoln, RN-Registered Nurse - Sarah Bush Lincoln