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RN Case Manager

Company: CHI St. Joseph's Health
Location: Bryan
Posted on: February 9, 2020

Job Description:

POSITION SUMMARY Coordinates patient care between patients, caregivers, and the multidisciplinary team; collects and evaluates information to facilitate care by assuring that admissions, continued stays, and ancillary services are medically necessary, cost-effective, and providing the appropriate setting to qualify for reimbursement. The case manager intervenes when necessary to assure that case is care is coordinated and timely. POSITION RESPONSIBILITIES 1. Documents on the day of admission, or within the first twenty four hours, a clinical assessment and anticipated discharge plan that addresses use of the full continuum of care 2. Provides plan of care updates to providers inside and outside of the hospital, working with patients and caregivers 3. Continually Assesses and modifies the plan of care based on clinical need and patient preference 4. Manages each patient's plan of care and throughout the stay 5. Leads interdisciplinary rounds to coordinate care with the care team, and to address changes in the discharge plan 6. Consults with appropriate physicians on plan of care and discharge 7. Remains current of Medicare and Medicaid laws and guidelines, Medicare Conditions of Participation, managed care contracts, and other legal and regulatory requirements as they relate to health care case management services. Assures patients are informed of rights and responsibilities as participants in these programs. POSITION SUMMARY Coordinates patient care between patients, caregivers, and the multidisciplinary team; collects and evaluates information to facilitate care by assuring that admissions, continued stays, and ancillary services are medically necessary, cost-effective, and providing the appropriate setting to qualify for reimbursement. The case manager intervenes when necessary to assure that case is care is coordinated and timely. POSITION RESPONSIBILITIES 1. Documents on the day of admission, or within the first twenty four hours, a clinical assessment and anticipated discharge plan that addresses use of the full continuum of care 2. Provides plan of care updates to providers inside and outside of the hospital, working with patients and caregivers 3. Continually Assesses and modifies the plan of care based on clinical need and patient preference 4. Manages each patient's plan of care and throughout the stay 5. Leads interdisciplinary rounds to coordinate care with the care team, and to address changes in the discharge plan 6. Consults with appropriate physicians on plan of care and discharge 7. Remains current of Medicare and Medicaid laws and guidelines, Medicare Conditions of Participation, managed care contracts, and other legal and regulatory requirements as they relate to health care case management services. Assures patients are informed of rights and responsibilities as participants in these programs. MINIMUM QUALIFICATIONS Education and Licensure Required: *Bachelor's Degree - Nursing OR ADN and 5 years of clinical experience *Registered Nurse (RN) licensure Minimum Experience: *Three (3) years of clinical nursing experience in the acute care or medical setting OR ADN and 5 years of clinical experience Minimum Knowledge, Skills, and Abilities: *Clinical practice with experience acquired in assigned specialty required *Computer skills required; must be able to document in medical records *Exercises knowledgeable, independent judgment on routine and non-routine matters Additional Information Requisition ID: 2019-R0262931 Schedule: Part-time Market: CHI St. Joseph's Health SDL2017

Keywords: CHI St. Joseph's Health, Bryan , RN Case Manager, Executive , Bryan, Texas

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