Case Manager

Description: SHIFT: 5 DAYS, 8 HR/DAY**MAY BE ASKED TO ARRIVE 7:30A AND MUST STAY UNTIL ALL CASES FINISHED FOR THE DAY**Must have at least 2 years experience20-25 case load dailyHIGH PACE environmentExperience

REQUIRED: Case Management, utilization, MCG criteria, InterQual criteria, EPIC.Acute Hospital Management highly preferredSummary:TheCareManager(CM)IIworksincollaborationwiththepatient/family,physiciansandmultidisciplinaryteammemberstoensurepatientprogressionthroughthecontinuumofcareandtodevelopaplanofcareforeachassignedpatientfromadmissionthroughdischarge.TheCMisresponsibleforidentifying,initiatingandmanagingoptimalpatientflow/throughputtoenhancecontinuityofcare,smoothandsafetransitions,patientsatisfaction,patientsafety,andlengthofstaymanagement.Supportandexpertiseareprovidedthroughcomprehensiveassessment,planning,implementation,andoverallevaluationofindividualpatientneeds.CareCoordinationandDischargePlanningarebothresponsibilitiesofthisrole.TheCMassessesandrespondstopatient/familyneedsbycoordinatingeffortsofotherteammembersandidentifiesandresolvesbarriersthathindereffectivepatientcare.TheCMadherestodepartmentalandorganizationalgoals,objectives,standardsofperformance,policiesandprocedures,andcontinuallyassuresregulatorycompliance.Responsibilities:MeetsexpectationsoftheapplicableOneCHRISTUSCompetencies:LeaderofSelf,LeaderofOthers,orLeaderofLeaders.Coordinatestheintegrationofcasemanagementfunctionsintothepatientcareanddischargeplanningprocessesincollaborationwithotherhospitaldepartments,externalserviceorganizations,agencies,andhealthcarefacilities.Coordinates/facilitatespatientcareprogressionthroughoutthecontinuumofcareinanefficientandcost-effectivemanner.Servesasresource,providessupport,andadvocatesonbehalfofthepatientrelatedtotreatmentdecisionsandendoflifeissues.Closelymonitorpatientlengthofstayinregardtothegeometricmeanlengthofstayandcommunicate/collaboratewithappropriateinterdisciplinaryteammemberstoremovebarriersandexpeditedischarge.Implementsandmonitorsthepatient splanofcaretoensureeffectivenessandappropriatenessofservices.Identifiesandescalateslocalandsystembarriersthatareimpedingdiagnosticortreatmentprogressandissuesrelatedtoqualityandriskasappropriateinatimelymanner.Proactivelyidentifiesandresolvesdelaysandobstaclestodischarge.Usesadvancedconflictresolutionskillsasnecessarytoensuretimelyresolutionofissues.Collaborateswithmedicalstaff,nursingstaff,andancillarystafftoeliminatebarrierstoefficientdeliveryofcareintheappropriatesetting.Interviewspatients/familiestoobtaininformationaboutsocial,emotional,andfinancialfactorswhichimpacthealthstatustodevelopcomprehensivedischargeplanningassessmentandcareplan.Assessesneedsfordischargeplanningandcontinuingcare/resourcesupportfollowingdischarge;independentlymakesrecommendationstopatientsandfamiliesregardingpost-acutelevelofcareneedsandoptionsincluding:AcuteRehabilitationPlacementNursingHomeorSkilledNursingplacementPsychiatricorSubstanceAbuseplacementNewDialysisChild/Adult/DomesticAbuseHomeHealth/HospiceReferralsLegalissues(adoptions,guardianship)AssistancewithAdvanceDirectivesCommunityResourceneedsFinancialIssues/FundingoptionsDMEReferralsandCoordinationSocialDeterminantsofHealthInitiatesdischargeplanningatthetimeofadmissionandmakespost-hospitalservicereferralsbaseduponinformationgatheredduringassessmentandinteractionswithphysicians,multidisciplinarycareteam,andpayorsasindicated.Actsaspatientadvocatebynegotiatingfor,andcoordinating,resourceswithpayors,agencies,andvendors.Ensuresthatallelementscriticaltotheplanofcarehavebeencommunicatedtothepatient/familyandmembersofthehealthcareteamandaredocumentedasnecessarytoassurecontinuityofcare.Provideappropriateinterventionswhichdemonstrateknowledgeofandsensitivitytowardculturaldiversityandthereligious,developmental,healthliteracy,andeducationalbackgroundsofthepatientpopulation.Assessesthepatient sformalandinformalsupportsystemaswellasavailablebenefitsand/orcommunityresources.Meetsdirectlywithpatient/familytoassessneedsanddevelopandindividualizedcareplanincollaborationwiththephysician.Ensuresandmaintainsplanconsensusfrompatient/family,physicianandpayor.Provideseducation,information,direction,andsupportrelatedtopatient sgoalsofcare.Actsaspatientadvocatetodeveloptreatmentplanandcoordinatepatientcareandtotransitionpatienttotheappropriatenextlevelofcare.Demonstratesandpromotesrespectforthedignityandrightsofeverypatientwhileadheringtothesafetystandardsandpracticesoftheorganizationandthenursingprofession.Collaborateswiththephysicianandotherhealthcareprofessionalstopromoteappropriateuseofmedicalcenterresources.Providesinformationandsupporttopatientsandfamilies,helpingthemaccessneededresourceswithinthemedicalcenterandcommunity.Activelyparticipatesinclinicalperformanceimprovementactivitiesinvolvinglengthofstay,resourceutilization,avoidabledays,costpercase,andreadmissions.Measureseffectivenessofinterventionsthroughdirectcommunicationwithpost-acutecareproviders,patients,andcaregivers.Promotesindividualprofessionalgrowthanddevelopmentbymeetingrequirementsformandatory/continuingeducationandskillscompetency.ActivelyparticipatesinMultidisciplinary/PatientCareProgressionRounds.EscalatescasesasappropriateandperpolicytoPhysicianAdvisorsand/orCMDirector.Documentsinthemedicalrecordperregulatoryanddepartmentguidelines.Maybeaskedtoassistwithspecialprojects.Mayserveapreceptorororientertonewassociates.Assumesresponsibilityforprofessionalgrowthanddevelopment.Musthaveexcellentverbalandwrittencommunicationandabilitytointeractwithdiversepopulations.Musthavecriticalandanalyticalthinkingskills.Musthavedemonstratedclinicalcompetency.MusthavetheabilitytoMultitaskandtofunctioninastressfulandfastpacedenvironment.Musthaveworkingknowledgeofdischargeplanning,utilizationmanagement,casemanagement,performanceimprovement,andmanagedcarereimbursement.Musthaveunderstandingofpre-acuteandpost-acutelevelsofcareandcommunityresources.Musthaveabilitytoworkindependentlyandexercisesoundjudgmentininteractionswithphysicians,payors,patientsandtheirfamilies.Mustbeunderstandingofinternalandexternalresourcesandknowledgeofavailablecommunityresources.Musthavetheabilitytomovearoundthehospitaltoallareasforthemajorityoftheworkdaywhileinofficetherestoftheday;generalofficeandhospitalenvironment.JobRequirements:Education/SkillsGraduateofanaccreditedschoolofnursing(BSNpreferred)orMastersDegreeinSocialWork(MSW)requiredordemonstratedsuccessinCHRISTUSCareManagerIPositionforatleast5yearsontopoftherequiredexperienceinlieuofeducationrequired.ExperienceTwoormoreyearsclinicalexperiencewithoneyearintheacutecaresettingpreferred.Licenses,Registrations,orCertificationsRNorLMSWinthestateofTX isrequiredfornewhires.LBSWacceptedforassociateswith5+yearsofdemonstratedsuccessandexperienceinCHRISTUSCareManagerIrole.CertificationinCaseManagementpreferred.BLSpreferred.WorkSchedule:5Days-8HoursWorkType:FullTime General Comments**MAYBEASKEDTOARRIVE7:30AANDMUSTSTAYUNTILALLCASESFINISHEDFORTHEDAY**20-25caseloaddailyHIGHPACEenvironmentExperienceREQUIRED:CaseManagement,utilization,MCGcriteria,InterQualcriteria,EPIC.AcuteHospitalManagementhighlypreferredMusthaveatleast2yearsexperience Position creation reason:Vacant

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