Responsible to coordinate interdisciplinary professional care of a select patient population as determined by individualized plan of care, clinical pathways, managed care guidelines and contracts. Mobilizes resources and manages the systems to respond to concurrent and respective data analysis, identifying variances. Participates in developing programs to improve clinical quality and fiscal outcomes, maintains knowledge of and responds to clinical system and fiscal data related to specific patient populations.
As a member of the care team participates in care conferences and attends nursing report, physician rounds, and interprofessional rounds. Contributes to the formulation, implementation, and evaluation of the treatment plan. Care is individualized by discussing expected progress toward recovery, intervening at key points of care upon identification of significant variances, and evaluating discharge readiness and plans to accomplish discharge.
In consultation with interprofessional team develops a treatment plan for patients based upon their clinical condition.
Serve as a catalyst to mobilize resources; assists in designing and evaluating systems that respond to patient, family, and provider needs.
Participate in data collection that includes patient care outcomes, resource consumption, and family and staff satisfaction. These data are then used to continually refine / improve quality of care, identify appropriate resource utilization, and promote family and staff satisfaction.
Recommend alternative locations of care when appropriate.
Coordinate discharge instructions to families of all patients on service. Assess problems and intervenes appropriately in conjunction with nursing staff. Assure that all critical elements of the plan of care are communicated to the family and PCP and are documented on the interprofessional plan. Communicate handoff of care plan to outpatient coordinator.
Document case management activity in the medical record to assure placement in the appropriate level of care by utilizing knowledge of insurance regulation, patients response to therapy, and cost effective care protocols.
Negotiate favorable scheduling sequences with ancillary departments for diagnostic tests and therapeutic treatments to avoid duplicative work and delays in care.
Participate in the interprofessional development of service specific protocols and their application to clinical practice.
Track outcomes and variances providing feedback to interprofessional team on clinical pathways.
Evaluate practice issues / outcomes for potential research opportunities, supports current research activities, and incorporates research results into pathway revisions.
Adhere to hospital and departmental policies and practices regarding confidentiality and patients' rights.
Provide peer consultation by assisting other case managers with complex cases.
Bachelor's degree in Nursing Two (2) years nursing experience
Currently licensed to practice as a registered nurse by the State of employment
If chosen for this position, you may required to pass a Post Offer Employment Physical Exam in accordance with the measurements listed in the Work Task Analysis (WTA) report. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities.
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