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RN-Case Mgr Prof Other (2301) in Cleveland, MS at Bolivar Medical Center

Date Posted: 4/20/2019

Job Snapshot

Job Description

Bolivar Medical Center

Responsible for the coordination and implementation of case management strategies pursuant to the Case Management Plan.  Plans and coordinates care of the patient from pre-hospitalization through discharge.  Works with all members of the healthcare team to assure a collaborative approach is maintained in care and treatment of the patient.  Reviews care and treatment for appropriateness against screening criteria and for infection control, quality and risk assessment documenting same in computerized database.  Responsible for authorization of appropriate services for continued stay and through discharge.  Performs length of stay management on a routine basis. Plans and coordinates home care services and needs.  Provides discharge planning and at home follow-up assessment (via telephone, in some cases may make home visit). Coordinates the discharge planning function in conjunction with the social worker, assist Quality Management Coordinator and Risk Manager with screening, investigation and problem solving as needed.  Assists the Utilization Management Department with all utilization activities as requested and directed. Participates in education on and implementation of clinical guidelines and protocols.  Provides or arranges patient teaching as appropriate.  Continues contact with patients with chronic diagnoses to assist with life style changes as needed to prevent recurrence or exacerbation of chronic illness.  Meets with and patient and family to assist with disease management planning.  Works closely with social worker to integrate psychosocial management of patient/family needs.  Participates in performance improvement activities, frequently attending and participating in performance improvement team efforts.

Job Requirements

  • Performs intake assessment on patient within 24 hours of admission (patients meeting screening criteria).
  • Performs follow-up assessments per Case Management Plan and/or department policy.
  • Utilizes clinical pathways whenever ordered by physician, to facilitate coordination of patient care.
  • Plans patient care in collaboration with all members of the healthcare team.
  • Keeps patient informed of progress and provides information related to disease progression.
  • Coordinates specialties when appropriate for optimal patient care.
  • Orders and arranges for home care equipment, healthcare needs.
  • Works with third party payers to validate need for patient care and home care environment needs.
  • Educates patient and family on all aspects of patient’s hospitalization and continuing care.
  • Reviews patient care activities for occurrences and trends that affect the quality, cost effectiveness and delivery of services.  Assures that the outcome of review is appropriately maintained in the computer database.
  • Assumes responsibility for timely completion of required case management reports for regulatory bodies, health plans, reinsurance carriers and the PMG/IPA Board of Directors.
  • Demonstrates an ability to be flexible, organized and function under stressful situations.
  • Maintains a good working relationship both within the department and with other departments.
  • Consults other departments, as appropriate, to collaborate in patient care and performance improvement activities.  Collaborates with other departments to identify operational problems and develop solutions/resolution.
  • Functions as a patient/family advocate.
  • Documentation meets current standards and policies.
  • Assures patient returned from hospital to safe environment.
  • Maintains optimal continuum of patient care through efficient and effective planning, assessing and coordination of healthcare services.
Professional Requirements:
  • Remains current on case management theory and practice, psychosocial issues current within the community and the healthcare environment.
  • Maintains current licensure.
  • Maintains regulatory requirements.
  • Reports to work on time and as scheduled, completes work within designated time.
  • Wears identification while on duty, maintains neat, clean attire.
  • Completes inservices and site audits, returning in timely fashion.
  • Attends Utilization Management Committee, performance improvement and departmental meetings as appropriate.
Regulatory Requirements:
  • Current State Registered Nurse Licensure.
  • 1 or more years case management experience.
  • 3 or more years acute hospital, home health, hospice, inpatient mental facility experience required.
  • Current BLS certification.

Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran


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