Nurse Case Manager

About the role

Reports to the Manager or Director of Case Management. Provides coordinated care support to facilitate and expedite patient care services. Participates in daily rounds and collaborates with the clinical healthcare team across the patient care continuum to include preadmission and post hospital discharge.

Responsibilities

• Participates in daily care rounds to collaborate with members of the patient 's healthcare team as well as to evaluate and facilitate development and implementation of the discharge planning process.
• Develops the initial patient discharge plan and reviews with patient, family members and other members of the interdisciplinary team.
• Reassesses the discharge plan daily during collaborative care rounds.
• Proactively builds post hospital referrals and sends to the Transition Care Coordinator when indicated to facilitate timely discharge.
• Delivers Important Message follow-up notices to all Medicare patients according to CMS regulations.
• Follows CMS and DOH regulations in relationship to discharge guidelines and patient rights.
• Carefully coordinates the length of stay with the physician care team and patient.
• Ensures team is informed of insurance qualifiers that may affect the discharge plan.
• Discusses approaching discharge readiness of patients.
• Identifies and assesses readmitted patients and complex patients in collaboration with members of the healthcare team to coordinate discharge.
• Advocates for the patient and advises the patient regarding financial implications of their discharge plan when coordinating care for the patient.
• Communicates the discharge plan, including post facility agency acceptance, to patients, families and all members of the care team.
• Documents final discharge disposition in progress notes.
• Develops appropriate patient care reports to ensure safe patient handovers occur as a patient is transferred from one patient care area to the next.
• Provides care plan direction for the advancement of a patient care delivery system which supports managed care strategies and decreases readmission risk.
• Acts as a change agent by identifying opportunities to improve patient flow and reduce service delays through problem resolution and follow-up.

Requirements

• Licensure as Registered Nurse in the State of Rhode Island by the Rhode Island Board of Nursing or licensure as a Registered Nurse in accordance with the Nurse Licensure Compact agreement of the National Council of State Boards of Nursing.
• Bachelor's Degree Required.
• Certification in Case Management by a nationally recognized organization preferred.
• AHA BLS Provider Required.
• Three years of clinical experience with recent experience in case management, community case management, patient navigation, or discharge planning is strongly preferred.
• Strong analytical and interpersonal skills are required to provide guidance to and communicate daily with healthcare professionals, patients and families.
• Demonstrates knowledge and skills necessary to provide care to patients throughout the life span with consideration of aging processes human development stages and cultural patterns in each step of the care process.
• Must be proficient in the use of Microsoft Office software including email and Outlook calendar and have basic keyboarding skills.

Qualifications

• Minimum Qualifications: Licensure as Registered Nurse in the State of Rhode Island by the Rhode Island Board of Nursing or licensure as a Registered Nurse in accordance with the Nurse Licensure Compact agreement of the National Council of State Boards of Nursing.
• Basic Knowledge: Graduate of a School of Nursing with current license to practice as a Registered Nurse in the State of Rhode Island.
• Experience: Three years of clinical experience with recent experience in case management, community case management, patient navigation, or discharge planning is strongly preferred.
• Skills: Strong analytical and interpersonal skills are required to provide guidance to and communicate daily with healthcare professionals, patients and families.

Skills

• Knowledge of federal and state rules and regulations.
• Knowledge of managed care requirements and patient care services.
• Ability to identify opportunities to improve patient flow and reduce service delays through problem resolution and follow-up.
• Ability to track service and discharge patient delays.
• Ability to participate in departmental and/or interdepartmental quality improvement activities as requested.
• Ability to orient new staff as requested.
• Ability to participate in ongoing education-related professional activities and affiliations.

Benefits

Full time, part time per diem and job share schedules available.

Pay

$90,417.60-$146,640.00

Schedule

Monday - Friday 8am-430pm, Rotating weekends and holidays