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Traveling RN Case Manager (Days)
Bay City, Michigan
Traveling RN Case Manager (Days)
- Provides overall technical direction and administration to case management and utilization review personnel, ensuring services are provided efficiently and effectively.
- Regularly reviews and revises, as necessary, relevant standards and ensures services performed comply with all hospital, system, and regulatory agency standards.
- Coordinates provision of services with other nursing and medical functions and serves as technical resource for departmental personnel.
- As an expert in the assigned area, is a resource person to both staff and physicians.
- Oversees, guides, and mentors the entire team to ensure patients (a) receive the right level of care at the right time predictably and (b) requiring referral care and/or services receive them in a timely manner.
- Performs care coordination assessments for initial assessment of patients with 24 hrs. of admission. assessments for readmission and transition planning.
- Works collaboratively with the social worker and other disciplines to ensure a safe, appropriate, and timely transition to the next level of care, taking into consideration the patient’s available resources.
- Assesses patient/family needs to reduce barriers and formulate discharge plans (e.g., LOS barriers to D/C).
- Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers.
- Reviews current DRG/LOS identified within Cerner to assess discharge planning needs with providers and identifies which family member is the point of contact.
- Assesses risk of readmission for specified patient populations and initiates assigned interventions that will enhance the patient’s ability to successfully transition along the care continuum.
- Performs discharge planning coordination/referral by making appropriate referrals to social services, ancillary departments, outpatient case management, DME, post-acute placement, and other outside agencies per Standard Operating Procedure (SOP).
- Acts as a liaison by collaborating and communicating daily with the physician, patient, family, nursing, and other members of the healthcare team.
- Actively participates in clinical case review/rounds with the interdisciplinary team.
- Documents in the electronic medical record (EMR): assessment, plans, interventions, barriers, and reassessments to facilitate discharges and/or transitions, manages anticipated discharge date and ensures all pertinent information is transferred to post-acute agency.
- Identifies barriers early in the patient’s stay, formulating a plan with the patient, family, internal and external members of the healthcare team, payers, and community resources.
- Identifies and reports avoidable day/variances and/or service delays from established plan of care to leadership.
- Represents the integrated care management department on various teams and performance outcomes committees and projects.
- Ensures patients follow up appointment with PCP has been made prior to discharge.
- Maintains effective operations by following policies and procedures.
- Performs other related duties as required and directed.
- 3+ Years if experience - Required
- Bachelor's Degree in Nursing- Required
- American Case Management Certification (ACM) or obtain certification when eligible as defined by the Association Case Management Association, and maintenance of continuing education requirements - Required
- Basic Life Support (BLS) certification as a Healthcare Provider by the American Heart Association, American Red Cross or equivalent through the Military Training network (MTN) - Preferred
- Experience in utilization management/case management, critical care, or patient outcomes/quality management- preferred
- Certification in Case Management Certification (ACM or CCM)- Preferred
- BLS (AHA)
STATE LICENSE REQUIREMENTS