RN Case Manager Inpatient - Care Coordination

Overview

Location
: 2400 Unser Blvd, Rio Rancho, New Mexico 87124, United States of America

Compensation
:
Minimum Offer $34.68;
Maximum Offer up to $52.95

Summary
:
Make a difference. Presbyterian Rust Medical Center is hiring an RN Case Manager to provide clinically-based case management that supports the delivery of effective and efficient patient care. The role integrates utilization management, care coordination, and transition planning. The Case Manager has accountability for a designated caseload and plans to meet patients’ needs, manage length of stay, and promote efficient resource utilization.

In collaboration with the interdisciplinary team, the Case Manager supports the physician in facilitating patient care to enhance quality outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers.

Growth and Development
:
Educational and career development options, including tuition and certification reimbursement and scholarship opportunities. Staff safety programs and differential pay for eligible shifts, higher education, certifications and lead roles. Malpractice liability insurance. Loan forgiveness through the New Mexico Higher Education Department. Epic electronic charting system.

Type Of Opportunity
:
Part time

FTE
: 0.6

Job Exempt
:
No

Work Shift
:
Days (United States of America)

RN Case Manager – Inpatient

• Interviews and assesses each patient, family or other designated person within 48 hours of admission to determine financial, emotional, physical, social, functional and health care needs; defines and recommends discharge plans; manages patient and family expectations; identifies readmission risk and targets interventions to reduce readmission; identifies and manages barriers to discharge.
• Applies approved clinical criteria to monitor appropriateness of admissions and continued stays; refers cases to Case Management Medical Director per departmental standards.
• Communicates required documentation to physicians to demonstrate medical necessity; elevates to Supervisor/Medical Director for patients not meeting criteria after discussion with physician.
• Educates patient, family, and interdisciplinary team regarding post-acute care options, status determination, and care coordination services.
• Develops and coordinates discharge plans with the interdisciplinary team, patient and family; ensures timely intervention to prevent delays and ensures all elements are communicated for continuity of care.
• Participates in daily multidisciplinary rounds; manages length of stay and escalates when needed to prevent over utilization.
• Leads complex rounds, discharge planning huddles, process improvement initiatives and department meetings.
• Identifies patients/families with complex psychosocial issues and refers to Social Work as appropriate; collaborates with Social Work partner.
• Facilitates patient/family and provider care conferences as needed.
• Documents assessments, status, interventions and discharge planning in the medical record per policies.
• Ensures safe patient care within policies and budgetary specifications; manages time, supplies, productivity and accuracy of practice.
• Supports professional growth and development and mentors less experienced staff.

RN IMM Case Management I

• Associates Degree in Nursing required.
• BSN within 5 years of hire date (preferred).
• Current New Mexico RN licensure required.
• 2 years clinical nursing experience in relevant practice area with utilization review or case management desirable.
• National Case Management certification preferred.

RN IMM Case Management II

• RN with BSN or ADN with five years of utilization review or case management experience; BSN within 5 years of hire date.
• Current NM RN licensure required.
• 2 years clinical nursing experience in relevant area required.
• National Case Management certification preferred.

RN IMM Case Management III

• Bachelor’s degree in nursing plus 5 years of utilization review or case management experience; or Master’s degree in Nursing.
• Current NM RN licensure required.
• 2 years clinical nursing experience in relevant area required.
• National Case Management certification preferred.

RN…