Registered Nurse, RN | Case Manager

About the role

This position offers relocation assistance up to $15,000 and is responsible for analyzing patient medical records, providing supportive documentation, coordinating discharge plans, and facilitating the continuum of care.

Responsibilities

• Evaluates medical information and completes discharge needs assessments within 1 day of admission.
• Initiates and completes safe discharge plans for inpatients, arranging referrals and interventions as needed.
• Documents initial assessment and continuously assesses discharge needs throughout the patient's care.
• Works closely with external vendors to arrange post-discharge needs and maintains positive relationships.
• Assesses variables impacting health and functioning, interprets clinical information, and identifies appropriate social service needs.
• Issues Important Messages from Medicare (IMM), MOON, and denial of services letters.
• Collaborates with Hospitalists and multidisciplinary teams to facilitate timely discharges.
• Enters Avoidable Days and Code 44 Documentation as appropriate.
• Provides information on “Advanced Directives” to patients and families upon request.
• Responds to outpatient and community inquiries and referrals.
• Screens patient records for quality assurance and discharge planning purposes.
• Facilitates placements or referrals to meet patient needs.
• Reports suspected abuse, neglect, or unsafe discharge environments to the appropriate agencies.
• Develops and implements individualized case management plans addressing physical, vocational, psychosocial, age, cultural, financial, and educational needs.
• Communicates with patients, families, and significant others to ensure appropriate post-hospital services and needs are met.
• Consults with social workers to identify appropriate social service needs.
• Provides necessary information to insurance carriers for authorization of follow-up care and post-discharge services.
• Collaborates with Case Management Manager to represent Case Management with internal medical or quality committees, inpatient nursing staff, and ancillary provider staff.
• Attends scheduled staff, care conferences, and other meetings as appropriate.
• Attends Utilization Review Committee meetings as schedule allows.
• Shares information from seminars and other sources of education with others as appropriate.

Requirements

• Associates Degree in Nursing with 3 years’ experience practicing as a RN, or Bachelor or Master of Science in Nursing with 2 years’ experience practicing as a RN.
• Strong clinical nursing skills with five (5) years hospital experience in varied clinical settings.
• Knowledge of insurance carriers and Medicare guidelines in the hospital environment.
• Knowledge of community health and social service resources.
• Current license as a Registered Nurse by the Oregon State Board of Nursing.
• American Heart Association Healthcare Provider BLS certification.
• Preferred certification in Case Management from ACMA or CMSA.

Qualifications

• Demonstrates ethical commitment to quality assurance and confidentiality of all data and information.
• Emulates dress code and Code of Conduct that incorporates presenting a good first and lasting impression by personal appearance and interpersonal skills.
• Advanced communication and interpersonal skills that utilize consideration of body language, filtering, listening, paraphrasing, and questions with customers of diverse ethnic and cultural backgrounds.
• Writes clear and legible clinical notes.
• Exhibits excellent telephone and interpersonal communication abilities, both verbal and written.
• Develops and coordinates case management care plans and solutions utilizing critical thinking and problem-solving skills.
• Familiar with computerized word processing and electronic medical records.
• Self-directed and able to follow through on projects with attention to detail and implement ideas and programs with minimal supervision.
• Applies problem-solving techniques to the case management process.
• Maintains familiarity with disease processes, available resources, and treatment modalities, assessing their quality and appropriateness for specific disabilities, illnesses, and injuries.
• Provides care appropriate to the age of patients served (pediatric, adolescent, adult, and geriatric).
• Demonstrates confidentiality according to PHI regarding patient and co-worker information.
• Understands insurance policy language and various health care options.
• Responds to correspondence independently, as appropriate.
• Shares findings with others.
• Maintains a cooperative and harmonious relationship with staff and management.
• Respects others, communicates clearly, and attempts to resolve interpersonal conflicts.
• Develops and maintains collegial relationships with other professionals by attending continuing education and professional group sessions.
• Preferrred bilingual skills.