Bozeman Health NON-CERTIFIED RN CASE MANAGER in Bozeman, Montana
NON-CERTIFIED RN CASE MANAGER
Bozeman Health Deaconess Hospital
BDH CASE MGMT
Casual Call (Per Diem/As Needed)
Mon-Fri 8-5pm with rotating weekends and holidays.
Job Details:POSITION DESCRIPTION POSITION SUMMARY Manage needs assessment, planning facilitation, and advocacy for options and services in order to meet customer health care needs through collaboration and communication, as well as, promote quality and cost effective outcomes. Coordinate care from admission through discharge achieving optimal patient outcomes. Provide discharge planning and resource referral based on the needs and assessment of the client. Support family members to assist them in understanding, dealing with, and supporting the patient. Actively involved in professional growth and promotion of case management roles and values. Performs utilization review and assignment of status based on specified criteria. Verifies medical necessity of patient admissions and continued stay. Initiates and maintains positive relationships with patients, customers and coworkers. Takes responsibility for self-development and supports a learning environment. Displays commitment to the mission of the hospital and its values. REQUIREMENTS EDUCATION Required: RN Associates Degree Preferred: RN Bachelors Degree LICENSURE and CERTIFICATION Required: Current Montana RN License CPR certified Preferred: EXPERIENCE Required: 2-5 years of nursing experience Preferred: 2-5 years experience in an acute care hospital ESSENTIAL FUNCTIONS 30% Time Spent - Clinical Management: Confer with physician to confirm appropriateness of patient's admission and continued stay in acute care environment Confirm doctor's treatment plan and intended goals with patient and family Encourage interventions appropriate to the reason for patient's admission Serve as patient advocate Initiate referrals to the appropriate areas to expedite care, treatment, and services Utilize evidence-based clinical protocols when warranted by patient's diagnosis Seek input from clinical experts to explore acceptable alternatives to treatment plan Convene and conduct interdisciplinary conferences to solicit input concerning the patient's treatment/discharge plan from clinical team members Collaborate with physician, patient, family members, and nurses to identify probable post-acute needs Coordinates all care of the high risk patient from admission through discharge Facilitates communication among team members 25% Time Spent - Resource Management: Ensure consistent data capture to identify trends/problems related to delivery-of-care delays, avoidable days, and non-acute contributory inpatient testing Issue Medicare HINN/ABN letters to patients when deemed necessary Provide clinical information to private payers per utilization review guidelines Assign patient status based on InterQual criteria in collaboration with physician Intervene with ancillary department leadership when timely service is critical to patient's immediate needs Identifies patients needing assistance from the Good Sam account 20% Time Spent - Transition Planning: Confer with health team members to identify patients in need of intensive post-acute services Confirm probable post-acute needs through supplemental assessment Collaborate with patient, family, physician, and team members to develop a transition plan appropriate to the patient's needs and financial capabilities. Determine patient's eligibility for post-acute services within 24 hours of inpatient admission Ensure that discharge plan implementation activities are conducted to effect a safe and timely transition to the community Serve as consultant and educator to patient and family Collaborate with payer representatives to advocate for patient's acute care and post-acute needs Locate appropriate community resources consistent with benefit eligibility Serve as liaison to community needs 20% Time Spent - Medical Documentation: Support concurrent coding and documentation improvement Counsel and inform doctors of the dimensions of accurate documentation Encourage medical documentation of deviations for protocols Document all discharge plans and utilization review information in medical record