Case Manager RN - Per Diem

About the role

The Case Manager is responsible and accountable for coordination of patient services through an interdisciplinary process, which provides a clinical and psychosocial approach through the continuum of care. Through concurrent case management, patients will be assessed to determine appropriateness of admission, continued hospitalization, as well as appropriate level of care. Discharge planning will begin at the time of (or prior to) admission, and reassessed ongoing throughout the course of hospitalization. Quality and Risk Management issues will also be monitored and reported as appropriate. CM may be assigned to various units throughout the hospital or the Emergency Department.

Schedule

• Required to work one weekend shift every two weeks
• Other days as needed
• This is an onsite position at a hospital facility in the Boulder CO regional area (not remote)

Primary Responsibilities

• Integrate the assessment of the need for post-hospital services and determination of an appropriate discharge plan for complex cases
• Educate patient/family as to options/choices within the level of care determined to be appropriate
• Initiate and ensure completion of all necessary paperwork
• Facilitate completion of orders as required prior to transfer of patient to the next level of care in a timely manner so discharge is not delayed
• Continuum of Care planning emphasizing education and collaboration with physicians, family members, clinical social workers, nursing staff, therapists and case managers from contracted payors when appropriate to determine discharge plan that will be of maximum benefit to the patient
• Involve staff from the next level of care in the treatment plan as early as possible to promote continuity and collaboration
• Report all relevant information to the staff assuming responsibility in the next level of care
• Comply with all regulatory requirements, including CMS and Joint Commission Standards
• Demonstrate working knowledge of managed care and Medicare health plans as well as reimbursement related to post-acute services within the continuum of care
• Consult with physician section leaders for support in cases where continued stay is not appropriate, and case managers are unable to come to resolution by working with assigned physician
• Communicate with the department director LOS and financial information, as well as issues that may affect the Continuum of Care process
• Remain flexible to meet the needs of the hospital, which may include floating to other departments to assist as the patient's needs fluctuate
• Review the patient plan of care with the multi-disciplinary team
• Facilitate and participate in multi-disciplinary team care conferences for patients with complex problems
• Communicate in the medical record and verbally with the team to coordinate interventions and facilitate continuity of care
• Provide daily communication and collaboration with the patient care staff to provide continuous assessment, evaluation and continuum planning to assure the patient receives the appropriate level of care at the appropriate time
• Coordinate patient care processes to achieve desired quality outcomes and identify/control inappropriate resource utilization
• Facilitate patient and family education and promote continuity of care to achieve optimal patient outcomes
• Assure patient rights by offering a choice when appropriate

Professional Accountabilities

• Adhere to name badge/dress code compliance
• Effectively solve problems and actively pursue resolution
• Directly communicate with staff, physicians, patients and families in a professional and courteous manner
• Role model leadership behavior through courtesy, respect and efficiency
• Function without direct supervision, utilizing time constructively and organizing assignments for maximum productivity
• Arrange schedule to facilitate meeting with physicians for patient care rounds, team meetings and other opportunities to improve communication

Required Qualifications

• Registered Nurse (RN) with a current, active, unrestricted RN License in Colorado OR a Social Worker (either a Licensed Clinical Social Worker [LCSW] in Colorado or Master of Social Work [MSW] will qualify) or ability to obtain within 6 months of hire
• 2+ years of experience working as a clinician in an acute care setting with proficient knowledge of hospital workflows
• Live in the Boulder CO regional area (this position is location based and not open to remote work)
• Willing/able to work one weekend shift per two weeks and availability as needed

Preferred Qualifications

• Case management experience or certification
• Knowledge or understanding of community resources, policies, and procedures
• Solid clinical acumen with the ability to use sound judgment, deductive reasoning, and problem-solving skills
• Demonstrates a high level of organization with the ability to stay focused on the detail
• Demonstrates collaborative skills and ability to interact with people of diverse backgrounds
• Solid written and verbal communication skills
• Self-motivated and able to function in a fast-paced work environment
• Meets and maintains quality and productivity standards
• Solid working knowledge of Microsoft packages
• Ability to learn and understand various clinical software applications
• Proficient typing skills
• Effectively solves problems and actively pursues resolution
• Critical thinking and organizational skills

Pay

The hourly pay for this role will range from $29.00 to $52.00 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.

Benefits

In addition to your salary, we offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).