RN CARE MANAGER
Location: Lancaster New Hampshire
Description: Weeks Medical Center is in need of RN CARE MANAGER right now, this occupation will be placed in New Hampshire. Further informations about this occupation opportunity please read the description below. It has been determined that you are currently running a "Popup Blocker". In order to continue, please allow this site from within your "Popup
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RN CARE MANAGER
Location:
Weeks Medical Center
Department:
MEDICAL-SURGICAL
Shift:
Day shift Part-time
Job Details:
Position Summary
The Care Management Registered Nurse is responsible for overseeing all inpatients, observation patients and SNF patients from admission to discharge in a utilization review, discharge planning coordination and educational / support capacity. The nurse is responsible for utilizing the Nursing Process to ensure that quality care is provided to adult and pediatric patients as it relates to care management scope of practice, making quality referrals as appropriate. The RN Care Manager is expected to offer and provide feedback to both nursing, ancillary and physicians in regards to utilization review and discharge needs. Qualifications Entry Level/Minimum Qualifications: Current New Hampshire RN license. Current BLS certification required. ACLS preferr! ed. Computer skills: Microsoft Word required; Microsoft Excel,! e-mail, ability to adapt well to other computerized programs including Paragon programs (HPF, CCS), e-Clinical Works, e-Discharge, e-Studio and more. Minimum 2 years nursing experience in long term care, home health or acute care. Must recognize how all disciplines fit into the continuum of care. Care Management certification within 3 years of this position. The expectation is that ongoing progress towards certification occurs during this time. Excellent communication skills with a variety of different personality types. Ability to interact and provide direction to all levels of providers of care including physicians, surgeons, mid-level providers, ancillary staff and nursing. Understanding of disease processes and the response process of patients families. The ability to utilize this understanding to facilitate patient progress towards goals and discharge plan. Preferred Qualifications: Prior Inpatient Care Management experience. Inpatient nursing and critical care experi! ence. Knowledge and skills of Utilization Review criteria (Milliman, Interqual or MCAP). Prior experience with private insurance companies and successful justification of patient stays. Knowledge and skill with CPT, ICD-9CM and HCPCS coding and it’s relationship to billing preferred. BSN preferred.
Essential Functions of the Job Required skills and competencies. Has competency checklist been completed with all competencies met (i.e. job skills / knowledge, equipment knowledge)? Coordinates intake processes and assigns patients including admissions, observation, acute, ICU, SNF and ICF. Communicates with the Emergency Department, Physician’s Offices, E-Discharge, Surgical Services, etc. to coordinate the placement process of patients requiring a stay on the inpatient units. Assesses all admissions to determine both appropriate status and placement of the patient. Review that appropriate criteria is being met through reviewing the medical record including physici! an’s orders and other documentation by all disciplines. Educate ! staff regarding the admission and discharge process, the utilization review process and required documentation to support the hospital stay. Works with the Resource Specialist and coordinates and facilitates the IDT process with IDT meetings. Utilizes the care plan in the IDT and discharge planning process. Ensures documentation in each patient’s active medical record. Works closely with the hospitalist and the IDT to ensure the proper steps are being taken towards the discharge plan for each patient. Documents (daily) conversations with patients, families and healthcare providers in the current medical record. Communicate effectively with clients, their families, and health care professionals in regards to their admission and discharge disposition. Coordinate patient care conference when necessary to ensure all disciplines are working together to gain optimal outcomes for the hospital stay. Communicates with insurance companies regarding patients, authorizations as neces! sary for proper patient reimbursement and disposition. Process and interpret data reflective of the patient’s status to ensure the timely initiation, revision, and/or continuation of the appropriate plan of care as related to the overall care management and discharge process. Functions as Outflow Coordinator overseeing and facilitating discharges from the facility. Works to find placement for patients requiring further assistance once discharged from hospital. Coordinates transfers from the facility including emergent and planned transfers to other facilities. Performs all other duties as assigned.
Job Code:
60209050
Posted:
Sep-17-2013
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This occupation starts available on: Wed, 18 Sep 2013 00:49:42 GMT