The Case Plan Clinician is responsible for carrying out care coordination and utilization activities as assigned for a patient population to ensure safe and effective outcomes and utilization of resources across the continuum of care and the appropriate level of care. The Case Plan Clinician oversees interdisciplinary activity relevant to managing the patient population and integrating services and/or departments around the organizing principles of acute case management. This will include but is not limited to bedside interdisciplinary rounds. The Case Plan Clinician must be able to demonstrate the knowledge and skills necessary to provide services appropriate to age groups according to specific chronological age, developmental age, and/or psycho-social maturity. This role works to provide efficient coordination of care and resources with quality outcomes while minimizing costs and duplication of services. The Case Plan Clinician will work collaboratively with the management and staff involved in the patient’s plan of care and discharge planning process as well as those facilities, organizations, and individuals providing post discharge care and services. This position will facilitate creating a safe and effective discharge plan associated with patient/family healthcare goals with input obtained from the care team. Specific duties include assessing and screening patients for discharge needs, performing readmission prevention activities, coordinating and providing referrals for continuing care, and locating available community resources for patients. Accurate and efficient application of screening criteria will be applied to identify and support patients being placed in the appropriate hospital level of care. Clinical review summaries for utilization review and insurance submission are completed when assigned for a patient population.
MINIMUM QUALIFICATIONS
Education:
Graduation from an accredited School of Nursing. BSN graduate preferred.
Required length and type of experience:
Minimum of five (5) years recent experience in clinical nursing or related nursing field. (e.g. Case Management or Utilization Review)
Previous Care Management, Case Management or
Care Coordination experience preferred
Excellent critical thinking and communication skills
Strong computer skills
Required licensure, certification or registry:
Current licensure by Ohio State Board of Nursing.
ACM/CCM Certification helpful
Refer code: 8404106. Southwest General - The previous day - 2024-02-28 15:57
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