RN Case Manager, UofL Hospital
RN Case Manager, UofL Hospital
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1 Vacancy
Job Description
Primary Location:
University Hospital - UMCAddress:
530 South Jackson Street Louisville KY 40202Shift:
First Shift (United States of America)Job Description Summary:
The RN: Case Manager promotes optimal health care outcomes in accordance with the policies procedures applicable laws and contracts philosophy mission vision and values of UofL Health; assumes responsibility and accountability for the appropriate utilization of facilities and services; serves as a resource to physicians nurses and ancillary staff; conducts initial admission assessments; identifies patients who do not meet criteria and takes action to ensure patients receive the most appropriate level of care; actively participates in daily rapid rounds to coordinate care in conjunction with other members of the interdisciplinary healthcare team and provide and facilitate optimal health care/discharge planning; utilizes the nursing process (assess plan implement and evaluate) and management process (plan organize direct and control) to provide a framework for decision-making; maintains confidentiality of information; actively supports organizational goals and objectives by providing needed information to divisions and departments.Job Description:
Essential Functions:
Under the direction of the Manager or Director of Care Coordination or CNO the RN Case Manager performs activities which support the Care Coordination Department including:
Promotes optimal management of clinical resources by conducting timely initial admission assessments based on clinical indicators and anticipated service needs for appropriate level of hospital care; Validates patient demographics and payor source
Utilizes and contributes to the development of the multidisciplinary clinical assessment of patients on an on-going basis during the patients admission to ensure the quality and appropriateness of patient care
Implements reassesses and evaluates patient condition and coordinates plan of care daily; Develops patient specific plan of care based on the individual needs of the patients conversations with providers and other staff and documentation in electronic medical record (EMR.) Ensures updated plan of care is documented in the EMR
Coordinates the discharge needs of patients with necessary internal and external providers while protecting patient information
Performs timely professional and appropriate documentation as reflected in the Quality Review Audit process
Advocates for patient/family needs in a respectful non-judgmental and confidential manner
Serves as a liaison or facilitator for the patient and interdisciplinary healthcare team in the management of unusual or questions cases. Educates the healthcare team about the role of the RN: Case Manager. Is accessible to the healthcare team as a resource.
Appropriately refers cases to manager/director of care coordination CAO or medical director when intensity of service or severity of illness is not present and is unable to be resolved
Ensure delivery of Discharge Medicare Important Message (IM) and Medicare Outpatient Observation Notice (MOON) where applicable
Acknowledges addresses and completes are Consults to Case Management on respective units in EMR
Other Functions:
Works collaboratively with social workers to identify social and financial barriers and community resources
Completes referrals to Social Worker for patients with high-risk indicators
Attends monthly departmental staff communications meetings. Serves as an active member of committees as needed which may include a variety of projects or topics
Enhances professional growth and development through participation in educational programs reading current literature attending in-service meetings and workshops that are related to assigned areas of responsibility. Assumes responsibility of growth and development maintains competency in care management principles
Educates physicians patients and staff with regards to payors financial issues documentation and potential compliance issues
Serves as a resource to physicians for clinical management and financial issues. Assists the providers with promoting efficiencies in the care delivery system and reducing/ eliminating barriers to efficient/effective service
Maintains compliance with all company policies procedures and standards of conduct
Complies with HIPAA privacy and security requirements to maintain confidentiality at all times
Performs other duties as assigned
A Note on Required Qualifications:
If individual holds an AS in Nursing they must be actively pursing their Bachelors Degree in Nursing Business Health Care Administration or equivalent; Bachelors Degree completion is required within 3 years of date of hire.
UofL Health will accept a Nurse Licensure Compact (NLC) from the NCSBN in lieu of a Kentucky Nursing License per the KBN.
Additional Job Description:
Required Experience:
Manager
Employment Type
Full-Time
