Case Manager, RN
Assessment
Initial screens all elective inpatient admissions related to Level of Care, Appropriateness of admission (IS-SI), Discharge needs, Third party contractual arrangements, and Appropriate resource utilization.
Coordinates pre-admission screening and education of identified patient populations.
Documents patients admitted directly through Pre-Admissions in the laptop system and forwards discharge planning concerns and the initial discharge-planning screen.
Technical And Job Specific Skills
Develops educational programs (pre/post op surgeries), high-risk screening tools, Care-Maps for the Pre-Admit phase of identified populations, and proactive discharge planning.
Serves as a source in selecting and assigning admission types (i.e. In Patients, 2359, SOS, etc.).
Interacts with the admitting MD as appropriate involving the Physician Adviser as needed for inappropriate admits/transfers/level of care.
Oversees that Pre-Admit TAR's are obtained and patients' payer sources have the appropriate network among the patients' healthcare team (i.e. Case Mgmt, Business Office, Physicians, Social Services, Nurse Manager, etc.).
Maintains identified tracking and data statistics as requested by the Quality/Case Management Department.
Performance/Process Improvement
Aware of and follows all hospital and department process policies and procedures.
Knows and can verbalize knowledge of hospital-wide performance/process improvement activity.
Offers suggestions for departmental and/or hospital-wide performance/process improvement.
Guest/Interdepartmental Relations
Verbal and written feedback from patients, family members/significant others, medical staff, visitors and co-workers indicates behavior conducive to positive guest relations.
Consistently exhibits appropriate phone protocol (e.g., answers phones promptly, is courteous, helpful and identifies self and department).
Consistently contributes to the team effort (e.g., assists co-workers when need is observed or upon request, offers constructive suggestions rather than complaints).
Consistently displays cheerful and positive attitude.
Productivity
Maintains high productivity and performs efficiently regardless of whether the work volume is high or low.
Appropriately prioritizes work activities.
Responds to difficult situations with self-control and a positive attitude.
Makes decisions independently and knows when to ask for assistance.
Exercises good judgment and arrives at sound decisions.
Key Success Factors
Reports to work each regularly scheduled work day.
Ready for work at precise starting time and continues working until scheduled departure time.
Readily accepts work assignments in a positive manner.
Performs work that is accurate, neat and consistent.
Documentation is legible.
Keeps work area neat and maintains equipment in accordance with health and safety codes.
Reports safety issues and equipment failures appropriately.
Projects a professional image, follows the hospital dress code policy and/or department requirements.
Wears hospital ID badge at all times on duty.
Sensitive information including, but not limited to, patient records, charts, hospital documents and employee information is kept confidential without exception.
Completes annual requirements (PPD, requirements, Annual Update, Ethics Training, Licensure and/or Professional Certification) on time.
Communicates with nursing and other hospital personnel regarding laboratory procedures, results, etc.
Communicates in a clear, courteous and professional manner.
Professional Conduct
Has the willingness and ability to perform additional duties and responsibilities in different areas of the department as needed.
Follows established hospital and department policies.
No more than 2 written substantiated complaints representing a breach of policy, procedure or professional behavior since last evaluation.
Demonstrates the philosophy of team concept.
Participates in group projects and staff meetings with suggestions that enhance the work environment and increase productivity.
Communicates well with supervisor reporting problems with equipment, supplies, or procedures.
Requests assistance as appropriate.
Maintains confidentiality as related to job responsibilities.
Exhibits willingness to resolve problems as they arise.
Consistently projects positive professional image through appearance and behavior.
Completes assigned work within shift.
Professional Growth and Development
Completes annual safety updates within the established time frames.
Completes general and departmental orientation within established time frames.
Attends 100% of mandatory in-service programs.
Maintains licensure/certification as appropriate.
Attends 75% of staff meetings or reads and initials minutes.
Keeps up with reading memos without reminders.
Does continuing education programs on time and with good test scores.
Performance Improvement
Consistently strives to understand, anticipate and meet the needs, expectations and satisfaction levels of patients and other "customers."
Errors, inefficiencies and inaccuracies are brought to management's attention with suggestions for improvement.
Develops innovative solutions to departmental problems.
Identifies and implements methods of controlling costs or generating revenue while providing maximum value to both the patient/customer and the hospital.
Measures progress against quality goals.
Actively promotes our Attitude is Everything, Core Measure, No Pass Zone, Avatar and Front Stage/Back-Stage goals.
Additional Responsibilities
Coordinates and supervises data and reporting needs and provides timely discharge planning.
Frequent contact with other organization units, outside facilities staff to obtain, verify and/pr provide information for the discharge follow-up.
Answers inquiries and educates patients/family, physicians and hospital staff on discharge.
May coordinate and supervise Air & Ground transportation.
Coordinates and supervises cases and referral information (SNF, Home Health and DME).
Maintain the consistency and integrity of Case Management/Social Services bed track data.