RN CASE MANAGER 1
Company: Inova Health System
Location: Alexandria
Posted on: October 31, 2024
Job Description:
The RN Case Manager 1 provides discharge planning and continuity
of care for assigned patients in acute and post-acute settings.
Provides coordination of services and acts as key liaison between
patients, families and interdisciplinary healthcare members. Uses
utilization management techniques to determine the medical
necessity, appropriateness and efficiency of the use of healthcare
services, procedures and facilities. Responsible for the timely
regulatory compliance and facilitation of precertification and
payer authorization processes when indicated. Actively participates
in clinical performance improvement activities.
Job Responsibilities
- Collects delay and other data for specific performance and/or
outcome indicators. Assists in the collection and reporting of
resource and financial indicators including acute and post-acute
case mix, LOS, cost per case, excess days, resource utilization,
readmission rates, denials and appeals. Collects, analyzes and
addresses variances from plans of care and care paths with
physicians and/or other members of the healthcare team. Uses
concurrent variance data to drive practice changes and positively
impact outcomes. Documents key clinical path variances and outcomes
which relate to areas of direct responsibility (e.g. discharge
planning, chronic disease planning).
- Uses pathway data in collaboration with other disciplines to
ensure effective patient management concurrently. Ensures safe care
to patients by adhering to policies, procedures and standards
within budgetary specifications including time management, supply
management, productivity and accuracy of practice. Promotes
individual professional growth and development by meeting
requirements for mandatory/continuing education and skills
competency. Supports department based goals which contribute to the
success of the organization.
- Provides discharge planning and continuity of care for assigned
patients in the acute and post-acute setting. Initiates and
facilitates referrals to clinics, home healthcare, hospice, SNF,
acute rehab, LTAC, TCM, medical equipment and supplies as
indicated. Collaborates with the interdisciplinary healthcare team,
patients and families in the assessment and coordination of
discharge planning needs, delivery of post-discharge planning
needs, delivery of post-discharge services and transition of
patients from hospitals to the discharge setting as well as ongoing
care in the community. Documents relevant discharge planning
information in medical records according to department standards
and/or care management plans.
- Collaborates/communicates with internal and external case
managers. Understands pre-acute and post-acute resources. Provides
coordination of services and acts as a key Liaison between
patients, families and the interdisciplinary healthcare team
members. Work closely with members of patients' healthcare teams to
manage and coordinate all areas of patients' care. Works
holistically to ensure that healthcare plans and discharge plans
meet the physical, social and emotional needs of patients.
- Provides educational resources and/or referrals to patients and
patients' families to address identified needs such as social or
financial. Acts as an advocate for patients to resolve barriers to
care progression. Uses utilization management techniques to
determine the medical necessity, appropriateness and efficiency of
the use of healthcare services, procedures and facilities.
Requirements
- Bachelors Degree in Nursing (BSN). ADN candidates must obtain
BSN within five years of hire date.
- Licensed or eligible for licensure in the Commonwealth of
Virginia as a Registered Nurse (RN).
- One year of Case Management and/or Clinical Care experience.
Case Management experience highly preferred.
- Previous Case Management experience highly preferred.
- Basic Life Support (BLS) through the American Heart Association
prior to start date.
Keywords: Inova Health System, Alexandria , RN CASE MANAGER 1, Healthcare , Alexandria, Virginia
Didn't find what you're looking for? Search again!
Loading more jobs...