Registered Nurse Case Manager Lead; RN

Overview

Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the opportunity to make a meaningful impact in patients' lives while enjoying a supportive work environment that fosters professional growth and work-life balance. Ready to be a vital part of our mission? Apply today and bring your passion for nursing to a place where it truly matters!

• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance

Note:

Eligibility for benefits may vary by location and is determined by employment status.

The position manages the continuum of care for assigned patients and serves as the content expert and role model for department staff. The Lead Case Manager serves as the expert in all aspects of the role including care coordination, collaboration and facilitation, advocacy for patients and families, discharge planning and utilization review. The position serves as the department expert aka "Super User" of MIDAS, CERMe, Curaspan, Portal and MS4.

The Lead Case Manager has the primary responsibility for training new staff and providing education to all department staff when new initiatives are implemented. The position provides initial and annual Inter Qual training for RN Case Managers.

• Discharge Planning - Utilize the nursing process to conduct a thorough assessment of discharge needs beginning at admission and as care needs evolve to assure a seamless and safe patient transition to the most appropriate level of care that has the identified resources to meet the medical, nursing and psychosocial needs of the patient. Collaborate with the interdisciplinary team to implement the identified discharge plan.
• Develop and effectively utilize a network of information regarding community resources.
• Coordinate the discharge planning process in collaboration with social workers and other professional members of the interdisciplinary team.
• Appropriately delegate within the scope of practice discharge planning activities and supervise others involved with discharge planning including LPNs, Case Management Coordinators or other non‑licensed personnel.
• Identify appropriate post‑hospitalization care and services required.
• Develop post hospital plan of care with the patient and/or family, physician and external resources.
• Communicate and document discharge planning needs.
• Initiate appropriate and timely social services, palliative care or other specialty referrals.
• Provide necessary patient teaching relevant to discharge needs, post hospital care arrangements prior to discharge.
• Assess the patient prior to discharge to determine if the plan is appropriate and make necessary revisions.
• Keep the interdisciplinary care team informed of details of the discharge plan.
• Communicate essential information to the next care provider as described in the hospital discharge planning policy.
• Educate patient regarding their Medicare appeal rights and initiate the Detailed Notice of Discharge (DND) when the patient decides to appeal their discharge.
• Contact the Quality Improvement Organization (QIO) per established protocol detailed in the Hospital Issued Notice of Non‑Coverage (HINN).
• Consistently apply the utilization review process in accordance with the Code of Federal Regulations and Abrazo designated criteria for primary review.
• Use clinical information to reach correct admission status determinations and work with the interdisciplinary team to ensure care and services are medically necessary, cost effective, delivered efficiently and timely.
• Coordinate internal and external services to avoid under or over utilization of resources.
• Indicate the working DRG in MIDAS or other tools.
• Facilitate or participate in interdisciplinary team meetings or rounds.
• Review records…