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Form of workMountain View Hospital is looking for a Emergency Room Case Manager/Nurse/Social Worker to join our team!
Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valley – all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice.
Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply.
BENEFITS:
Taking care for our community starts with taking care of our own team. Mountain View Hospital is proud to offer its employees competitive and comprehensive benefit packages. Benefits include:
- Medical, Dental and Vision Insurance
- Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off
- Retirement Plans (401K with up to 6% match)
- Earned Quarterly Bonus Program
- Education Reimbursement Program
- Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital
- Life Insurance
- Short- and Long-Term Disability
- Flexible Spending Accounts
- Employee Assistance Program
- Flexible Schedules
- Collaborative and Supportive Work Environment
Please note benefits are based on eligibility according to full-time, part-time or PRN status classification.
JOB SUMMARY: Assists patients and families with personal and/or environmental difficulties which predispose illness or interfere with obtaining maximum benefits from medical care. Prepare patient and family for discharge from acute care hospital setting. Works in close collaboration with physician health care personnel in patient evaluation and treatment to further their understanding of significant social and emotional factors underlying patient’s health problems. Under the general direction of the UR / Case Manager and the UR Medical Director, the Utilization Review has the responsibility for assuring prompt, accurate handling of initial medical necessity reviews through the preauthorization and retrospective review process.
DUTIES AND RESPONSIBILITIES:
Emergency Room Case Manager/Nurse/Social Worker
1. Coordinate the discharge plan and services with the patient, families and disciplinary teams to ensure appropriate plan/services at discharge. Assist patient/family through individual or group conferences to understand, accept, and follow medical recommendations.
2. Ensure cost effective and appropriate health care services are provided to all patients regardless of patients funding. Assist the department head in the supervision of the utilization of resources to promote quality, cost-effective outcomes for the patient/family.
3. Prioritize the patients of need for case management. Provide initial assessment for patients looking for the physical, functional, social, psychological, environmental and financial needs of patients. Screens patients for social service, home care, and other community care needs. Identify risk factors and strengths of patient/family support system communicate findings with team members.
4. Assist with emotional support of patient/family members as needed. Identifying abuse/neglect and referring appropriately for evaluation and reporting. Screen for financial issues surrounding admissions and transfers, refers patients to financial counselor for information and financial assistance forms
5. Act as a patient advocate by aiding in acquiring appropriate care in the home or clinic setting as needed upon discharge. Assist with referrals to appropriate community resources. Utilizes community resources to assist patient to resume life in community or to learn to live within limits of disability.
6. Maintain accurate patient records, with through charting, ensuring patient confidentiality. Appropriately documents interventions performed.
7. Develop, coordinate, and present process improvement projects to improve productivity, patient outcomes and treatment modalities.
8. Assess ED patients and identify options other than acute hospital admission when appropriate. Screen and refer to acute rehabilitation, long-term acute care hospitals, and nursing homes for admission directly from the ED; screen and refer patients to clinics after initial exam. Screens and refer patients for whom treatments could be safely rendered at home with services (e.g., IV antibiotics, low molecular weight heparin injections, wound
care, etc.)
9. Follow-up with patients determined to be at high risk for adverse outcomes or readmission. Applies approved clinical appropriateness criteria to monitor appropriateness of inpatient admissions and observation stays and documents findings based on department standards.
10.Fulfill all regulations of an UM reviewer assigned including: Conduct daily reviews for all the assigned patients’ records for utilization management by using the InterQual Guidelines and documenting the criteria
11.Provide consultation and direction to admitting physicians regarding appropriate determination
of level of care and patient status (inpatient versus observation/outpatient).
12.Act as a resource to ED staff and physicians regarding admission, levels of care (including related documentation requirements and observation vs. inpatient requirements), quality of care concerns and criteria/guidelines/protocols utilized in care planning and resource utilization.
13.Gather sufficient information from and communicates with all relevant sources to facilitate appropriate discharge from ED to appropriate level of care. Ensure discharge is accurate, safe, timely and cost-effective manner to prevent readmission and/or frequent visits to ED.
14.Organize, integrate, and evaluate the effectiveness of the plan of care and progress toward achievement of desired outcomes. Modify plan of care as patient/family needs change to accomplish goals established.
15.Communicate plan of care, including changes and issues related to plan of care to patient/family, physicians, and other members of the healthcare team.
16.Use well developed knowledge and skills in patient status determination (InterQual Criteria), in
the assessment and care management of patients within the ED.
17.Practice patient/family assessment and management, resource management, identify patient’s
appropriate PSO admission, observation.
18.Collaborate with other Case Managers, social work staff, the access center, admissions, and other physician and administrative leadership staff within the ED, the care management department and both the inpatient and outpatient settings.
19.Perform initial review of inpatient cases applying evidenced-based criteria. (InterQual Criteria)
20.Participate in the educational program, completes annual educational requirements, and attends in-service meetings as required.
21.Other duties as assigned.
Education/Certification: Graduate from an accredited school of nursing with current license as an LPN or RN in the state of Idaho. Preferred experience in a healthcare facility.
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Experience: 3+ years Clinical Nursing or Relevant Social Work experience. Experience in case management, utilization management, and/or transitional care, preferred.
Equipment/Technology: Basic computer knowledge.
Language/Communication: Effective written and oral skills. Ability to comprehend and follow detailed instructions. Ability to effectively present information and respond to questions from groups of managers, patients, families, and the pressure during difficult circumstances. Speaks clearly and persuasively in positive or negative situations: listens and gets clarification.
Mathematical Skills: Business related math.
Mental Capabilities: Ability to organize, recognize, and correct inefficiencies, breakdown in system or communication and be able to assist with problem solving. Handle and prioritize multiple requests.
Interpersonal: Can remain pleasant under extreme pressure and during difficult circumstances. Ability to be cheerful, trustworthy, loyal and organized, with the ability to demonstrate professional behavior at all times, as an active member of the care team.
Reasoning Ability: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited
standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Be able to problem solve from a team prospective while be open to suggestion and constructive criticism.
Performance: Maintains strict confidentiality, exactness with great attention to detail, and ability to work with others. Ability to remain
politically neutral. Customer Service oriented.
Problem Solving: Identifies and resolves problems in a timely manner; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics.
Customer Service: Manages difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service. Responds to requests for service and assistance; meets commitments.
Interpersonal Skills: Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control.
Judgement: Exhibits sound and accurate judgment.
Professionalism: Approaches others in a tactful manner; reacts well under pressure; treats others with respect and consideration regardless of their status or position.
