Case Manager RN - Per Diem

Opportunities at Northern Light Health, in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities.

If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind:
Caring. Connecting. Growing together.

The Care Manager, RN provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients/caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Facilitates appropriate LOS, patient experience, and reimbursement for all patients. Develops and maintains collaborative relationships with all members of the healthcare team.

Through clinical care coordination drives efficient utilization of resources to reduce length of stay, improve patient flow and throughput, limits variation by applying innovative and evidence-based practice, and to reduce the risk of readmission.

You'll enjoy the flexibility to telecommute
* from anywhere within the U.S. as you take on some tough challenges.

• Effectively problem-solve and actively pursue resolution.
• Directly communicate with staff, physicians, patients, and families.
• Model leadership behavior through courtesy, respect, and efficiency.
• 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.
• 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.
• 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. Facilitate the implementation of nursing interventions as indicated by the multi-disciplinary team plan of care that enhances and complements the skill level of the nursing staff.
• Function without direct supervision, utilizing time constructively and organizing assignments for maximum productivity. Arrange schedule to facilitate meetings with physicians for patient care rounds, team meetings and other opportunities to improve communication.
• Adhere to name badge/dress code compliance.

• Knowledge of all applicable federal and state regulations. Demonstrates a 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 that continued stay is not appropriate, and case manager is 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.

• The CM will be responsible for integrating 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 insure 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 will emphasize 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 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.
• Employees are expected to comply with all regulatory requirements, including CMS and Joint Commission Standards.

• Interface with department directors, Risk Management, and patient representatives to identify potential QA or risk issues. Perform any necessary investigation, documentation and follow-up as required.
• Participate in departmental SQI projects.
• Must be able to functionally coordinate and discharge plan for all age groups, including but not…