RN-Care Management and Services

Responsibilities

• Identifies and assesses patients and families with possible social, psychological and/or environmental needs related to the impact of utilization patterns of care.
• Develops plans for intervention addressing agreed upon priorities, synchronizes supportive services and assists patients/families in improving or restoring their capacity for social functioning.
• Facilitates interdisciplinary huddles and collaboration throughout the work-day.
• Conducts 1:1 patient and family interviews on moderate and high risk patients.
• Evaluates readmission factors contributing toward inappropriate utilization of services.
• Collaborates with physicians, nursing, and ancillary services in development of safe, next-phase planning.
• Communicates Care Planning in written and/or verbal format to next level of care.
• Facilitates partnership with members across the continuum for aligned outcomes.
• Facilitates optimal care delivery, including weekend and holiday shift rotations.
• Performs primary documentation in EPIC and interfaces with other information systems for discharge planning, communication, patient/family education and evidence-based care.

Requirements

• Registered Nurse with a current license to practice in Ohio.
• Charge Nurse, Nurse Manager, Case Manager, Care Coordinator, Care Manager experience preferred.
• Bachelor's Degree (BSN) from an accredited school required, Master’s degree preferred.

Qualifications

Primary documentation occurs in EPIC however interfacing with other information systems occurs to facilitate discharge planning, communication, patient/family education and evidence-based care.

Skills

Knowledge of motivational interviewing techniques to assist patients toward healthier lifestyle choices.

Benefits

Variety of work hours including weekend and holiday shift rotations.

Pay

N/A

Schedule

N/A

Benefits

N/A