RN- Crohn's and Colitis Center

JOB PURPOSE OR MISSION: To improve the quality of life of patients and families by coordinating patient care processes of assessment, planning, implementation and evaluation in collaboration with the patient, family, physician, and appropriate support services for the age population served, as defined in the department's scope of service.

PERFORMANCE CRITERIA

CRITERIA A: Everyday Excellence Values - Employee demonstrates Everyday Excellence values in the day-to-day performance of their job.

PERFORMANCE STANDARDS:
Demonstrates courtesy and caring to each other, patients and their families, physicians, and the community.
Takes initiative in living our Everyday Excellence values and vital signs.
Takes initiative in identifying customer needs before the customer asks.
Participates in teamwork willingly and with enthusiasm.
Demonstrates respect for the dignity and privacy needs of customers through personal action and attention to the environment of care.
Keeps customers informed, answers customer questions and anticipates information needs of customers.

CRITERIA B: Corporate Compliance - Employee demonstrates commitment to the Code of Conduct, Conflict of Interest Guidelines, and the GHS Corporate Compliance Guidelines.

PERFORMANCE STANDARDS:
Practices diligence in fulfilling the regulatory and legal requirements of the position and department.
Maintains accurate and reliable patient/organizational records.
Maintains professional relationships with appropriate officials; communicates honesty and completely; behaves in a fair and nondiscriminatory manner in all professional contacts.

CRITERIA C: Personal Achievement - Employee demonstrates initiative in achieving work goals and meeting personal objectives.

PERFORMANCE STANDARDS:
Uses accepted procedures and practices to complete assignments. Uses creative and proactive solutions to achieve objectives even when workload and demands are high.
Adheres to high moral principles of honesty, loyalty, sincerity, and fairness.
Upholds the ethical standards of the organization.

CRITERIA D: Performance Improvement - Employee actively participates in Performance Improvement activities and incorporates quality improvement standards in his/her job performance.

PERFORMANCE STANDARDS:
Optimizes talents, skills, and abilities in achieving excellence in meeting and exceeding customer expectations.
Initiates or redesigns to continuously improve work processes.
Contributes ideas and suggestions to improve approaches to work processes.
Willingly participates in organization and/or department quality initiatives.

CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.

PERFORMANCE STANDARDS:
Effectively manages time and resources
Makes conscious effort to effectively utilize the resources of the organization - material, human, and financial.
Consistently looks for and uses resource saving processes.

CRITERIA F: Patient & Employee Safety - Employee actively participates in and demonstrates effective patient and employee safety practices.

PERFORMANCE STANDARDS:
Employee effectively communicates, demonstrates, coordinates and emphasizes patient and employee safety.
Employee proactively reports errors, potential errors, injuries or potential injuries.
Employee demonstrates departmental specific patient and employee safety standards at all times.
Employee demonstrates the use of proper safety techniques, equipment and devices and follows safety policies, procedures and plans.

JOB FUNCTIONS

ESSENTIAL JOB FUNCTIONS include, but are not limited to:

1. Coordinates patient assessment through collection of patient's health data.

PERFORMANCE STANDARDS:
Prioritizes data collection based on the patient's immediate condition or needs.
Involves the patient, significant others and health care providers as appropriate.
Coordinates care using evidence-based guidelines for the patient population.
Acts as liaison with patients and their families to physicians, specialty providers, hospital staff, health plan staff.
Identifies and coordinates the need for further assessment by other disciplines.

2. Analyzes patient assessments to determine nursing diagnoses and identifies expected outcomes.

PERFORMANCE STANDARDS:
Identifies patient outcomes based on the identified goals.
Demonstrates ability to proficiently assess patients in every age group.
Reviews and incorporates Gaps in Care, predictive model and other data reports into physician daily work flow for urgent and follow up office visits.
Generates preventive services reminders for clinicians and patients not following age and/or gender appropriate guidelines and incorporates into physician daily workflow.

3. Identifies and implements interventions as appropriate.

PERFORMANCE STANDARDS:
Uses interventions that are consistent with the patient's plan of care.
Maintains patient rights.
Provides individualized patient education to patient and families.
Collaborates with the interdisciplinary team to plan patient discharge.
Documents patient/family education and ongoing assessments.

4. Evaluates the patient's progress toward attainment of outcomes.

PERFORMANCE STANDARDS:
Performs ongoing and systematic reassessment according to department standard or more frequently based on patient condition.
Revises nursing diagnoses, outcomes and plan of care based on reassessments.
Involves the patient, significant others and healthcare team in the evaluation and update of plan of care as appropriate.
Evaluates the effectiveness of treatments, medications and patient teaching.
Actively supports patient self-management with assessments for barriers to compliance with plan of care.
Coordinates follow-up care for patients who receive inpatient and outpatient services.
Participates in the discharge planning process of PCMH patients; calls patients discharged from the hospital to schedule appointments within three days of discharge and collaborates with health plan staff for discharge planning activities.
Works with patients to identify risks for medication non-compliance and resolves barriers to ensure compliance.
Refers and promotes member participation in health plan's case/disease management programs.

5. Coordinates utilization of clinical and financial resources.

PERFORMANCE STANDARDS:
Performs admission review on all assigned patients within 24 hours of notification of admit for appropriateness of admission and level of care based on InterQual criteria.
Performs clinical and discharge assessment on all assigned patients.
Initiates discharge plans, communicates and collaborates with other healthcare professionals, and updates discharge plans as needed.
Arranges referrals to post acute providers.
Actively participates with other members of the healthcare team in the development and implementation of the plan of care.
Performs concurrent review for appropriateness of level of care and continued stay based on InterQual criteria.
Identifies and refers problem cases to Manager and/or Medical Director.
Maximizes reimbursement to BRG by:
o Communicating pertinent clinical information to payers
o Helping to ensure that the physician documentation supports appropriate coding
o Facilitating physician-to-physician conferences to avoid denial of payment.
Identifies opportunities for more efficient resource utilization.
Actively uses preferred providers and ancillary vendor listings (ambulatory surgery, high tech radiology and laboratory services) when referring patients for services.

6. Participates in quality improvement activities.

PERFORMANCE STANDARDS:
Reports sentinel events and quality of care issues to ICM Manager and Quality Management within 24 hours of identification.
Collects data on avoidable days and reports to ICM Manager.
Participates on performance improvement teams as needed.

EXPERIENCE REQUIREMENTS
3 years Nursing experience and an advanced degree or case management or chronic care certification, or five years of nursing experience in lieu of advanced degree or certification
2 years of case/disease management, quality improvement or community health experience
Related experience in care management, discharge planning, and home health care preferred

EDUCATIONAL REQUIREMENTS

SPECIAL SKILL, LICENSE AND KNOWLEDGE REQUIREMENTS
Current Louisiana RN licensure
Demonstrated ability to organize and prioritize work for optimal results
Excellent analytical and problem solving skills
Experience writing policies and procedures, project management and workflow design preferred

HIPAA REQUIREMENTS:
Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position including but not limited to: Medical records w/o limitation both paper and electronic, patient demographics, lab and radiology results, patient information related to surgery or appointment schedules, information related to patient location, and /or religious beliefs.

SAFETY REQUIREMENTS:
Maintains knowledge of and adherence to all applicable safety practices appropriate to Job Position including but not limited to: Incident reporting, PPE, exposure control plans, hand washing, patient identification, receives orders for all ages.