RN Case Manager-Emergency Department
RN Case Manager-Emergency Department
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Job Description
UPH Additional Information
Why UnityPoint Health
Commitment to our Team Were proud to be recognized as a Top 150 Place to Work in Healthcare by Beckers Healthcare several years in a row for our commitment to our team members.
Culture At UnityPoint Health you matter. Come for a fulfilling career and experience a culture guided by uncompromising values and an unwavering belief in doing whats right for the people we serve.
Benefits Our competitive Total Rewards program offers benefits options that align with your needs and priorities no matter what life stage youre in.
- Caring is what we do and it starts with our team members: expect paid time off parental leave 401K matching and an employee recognition program as we support you both personally and professionally.
- You can only give your best when you feel your best and we help you live well with dental and health insurance paid holidays short and longterm disability and more. We even offer pet insurance for your fourlegged family members to give you peace of mind.
- We strive to make things easier and more personal in health care to set us apart from the rest and you can experience that commitment through early access to earned wages with Daily Pay a tuition reimbursement program designed to help you further your career and adoption assistance to help you grow your family in the way that works for you.
Diversity Equity and Inclusion Commitment At UnityPoint Health we honor the ways people are unique and embrace what brings us together. Our collective goal is to champion a culture of belonging where everyone feels valued and respected.
Development We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience.
Community Involvement Be an essential part of our core purposeto improve the health of the people and communities we serve.
Hear more from our team members about why UnityPoint Health is a great place to work at
Overview
The Emergency Department (ED) Case Manager serves an integral role in the multidisciplinary effort to identify and deliver quality and cost efficient healthcare to patients. While the role is multifaceted concentrated effort is given to the oversight and collaborative coordination of care and services for a defined patient population ensuring that adequate discharge plans are in place and completing utilization management and quality review activities. The ED Case Manager teams with Social Services in guiding these efforts. Care is provided through a therapeutic relationship with the patient and family. A spirit of inquiry is encouraged and supported. Evidencedriven protocols are utilized to assure reliable and consistent care. The ED Case Manager collaborates with members of the interdisciplinary team to achieve department and hospital goals related to coordination of care reducing avoidable admissions and ensuring appropriate level of care.
The ED Case Manager is based primarily in the ED but is expected to provide care coordination and utilization review for other departments of the hospital as assigned.
Responsibilities
Clinical Excellence
- Participation in shared governance and performance improvement activities at the unit and hospitalwide level encouraged.
- . In the care coordinator role assumes responsibility for developing a plan of care including a discharge plan that is mutually established with the patient and family. Monitors patient progress towards goals. Each patient is treated as an individual with their identified goals and expectations reviewed to identify and verify priorities.
- In the care coordinator role facilitates communication with provider and healthcare team regarding current LOC status expected LOS plan of care focus goals progress towards goals and anticipated discharge needs.
- Facilitates communication with patient and family regarding current LOC status expected LOS plan of care focus goals progress towards goals and anticipated discharge needs. Provides explanations to patients and families regarding LOC status and implications of observation status versus inpatient status as appropriate.
- Recognizes potential and actual postdischarge needs and makes appropriate referrals to social work to enhance continuity of care. Assists in arranging postdischarge services including contact with insurance company for possible preauthorization requirements.
- Coordinates discharge plan with provider social services healthcare team patient and family. Communicates the discharge plan to the primary nurse and healthcare team through verbal updates and handoff tools. Discharge planning documentation is completed in the electronic medical record.
- Provides oversight for utilization of evidencebased care for patient populations.
- Assesses need for patient and family education. Participates with the healthcare team in identifying and providing health teaching and counseling as appropriate. Facilitates referrals to appropriate resources.
- Multidisciplinary patient care charting is done concurrently as care is provided to assure that goals of care and discharge planning activities are concurrently accessible to the healthcare team.
Regulatory Compliance
- Maintains knowledge of utilization management criteria and communicates with UM Coordinator to ensure medical necessity and appropriate patient class for hospital stay.
- Assesses ED patient for Level of Care (LOC) and Expected Length of Stay (LOS). Performs initial screening review for LOC determination. Assures provider order for LOC is present on the patient record.
- Ensures that ordered diagnostic tests procedures and treatments are preauthorized based on payer requirements and scheduling is coordinated for efficiency.
Communication
- Provides LOC and LOS coaching and guidance to providers in all health care settings.
- Collaborates with the multidisciplinary healthcare team to ensure the delivery of high quality evidencebased care.
- Collaborates closely with Social Services to facilitate discharge planning activities.
Qualifications
- Completion of an accredited nursing program with current RN licensure.
- Minimum of three years experience in a clinical setting preferred with recognized knowledge and expertise in caring for specific patient populations.
- Current Iowa nursing licensure
- Must be able to successfully complete a basic computer course through inhospital training.
- Must successfully complete inhospital orientation and competencies.
- Demonstrates skill organization and efficiency in performing required activities.
- Must have knowledge of Medicare Regulations and familiarity with Professional Review Organization regulations.
- Must have excellent oral and written communication skills with providers payers and consultants with the ability to negotiate and establish effective working relationships with members of the healthcare team.
- Knowledge of prospective payment systems QIO activities federal and state rules and regulations.
- Use of usual and customary equipment used to perform essential functions of the position.
Required Experience:
Manager
Employment Type
Part-Time
