RN Case Manager - Care Management

Description At Peacehealth, it's our vision that every person receives safe, compassionate care; every time, every touch. As a RN at Southwest Medical Center in Vancouver, WA, you'll be part of a collaborative team working together to ensure that our patients receive exceptional care. If this resonates with you, consider joining our Care Management team in the following role: Part-time .6 FTE evening shift RN Case Manager Work 8-hour evening shifts, 24 hours per week, 4pm - 12:30am We offer you : A wage range of $51.73 - $76.98, actual hiring rate is dependent upon several factors, including but not limited to, terms of the applicable collective bargaining agreement, education, training, work experience, etc. Additional compensation for BSN, MSN, DPN, and specialty nursing certification $2.50 evening shift differential Relocation Assistance Hiring Bonus A student loan repayment program A Professional Nurse Advance Program with pay incentives Eligible for full benefits effective the first of the month following start date Job Summary Responsible for coordinating and monitoring the patient's care including the daily plan and the plan for the stay. Performs patient care review activities including monitoring and correcting patient status, documentation for medical necessity of admission and continued hospitalization and concurrent review. Educates patients and families about their hospital course and identifying patient's discharge needs. Essential Functions Provide initial and ongoing assessments of the patients' needs for services in collaboration with the healthcare team. Monitor and evaluate utilization of those services to focus on the best treatment and approach for the patient promoting the timely progression of interventions, utilization of resources and expected outcomes within a length of stay consistent with external regulations and standards. Provide utilization management including facilitating appropriate status assignment per Medicare and InterQual criteria. Ensure appropriate documentation for medical necessity of admission and continued hospitalization. Ensure appropriate level of care bed assignment, apply/interpret payer criteria to ensure conformance with payer standards and provide insurance reviews. Implement opportunities to improve effectiveness in utilization. Provide transition planning coordination to include identifying needs and implementing referrals to other clinical care providers. Evaluate patient progress and revise the care plan if needed. Act as a resource for physician office, physician and staff regarding Intensity Severity Discharge (ISD) criteria. Identify barriers to achieving patients discharge and assist the care team in overcoming them. Provide patient/family education to facilitate an understanding of their hospital and post-hospital course, their status assignment and discharge appeal rights and provide advocacy for their care. Effectively communicate and provide clear and concise documentation according to department standards and regulatory requirements. Refer to appropriate internal and community resources as necessary. Act as care management resource by demonstrating critical thinking, portraying a professional image of competency to customer and staff and demonstrating effective verbal and written communication with everyone. Maintain knowledge of CMS, Medicaid, and regulatory agency standards, Department of Health (DOH), Emergency Medical Treatment and Active Labor Act (EMTALA). Serve as a clinical resource and/or liaison. Lead "progression of care" transition rounds, assigning cases to MSW/Discharge planner for intervention. Performs other duties as assigned. Qualifications Education Accredited School of Nursing Required Bachelor's Degree Preferred: Bachelor of Science in Nursing Experience Requires: Minimum of 3 years RN experience in a hospital setting with medical/surgical experience with supervisory/preceptor experience (or may have equivalent combination of education and/or experience) 1 year Preferred: Surgical patient population experience Credentials Required: WA State Registered Nurse License Required Upon Hire: Basic Life Support Certification Preferred Upon Hire: Certified Case Manager Skills Discharge planning, case management, quality assurance/quality improvement, clinical documentation and/or utilization management using Intensity Severity Discharge (ISD). (Preferred) Strong verbal, written and interpersonal communication skills. (Required) Extensive knowledge of diseases, clinical procedures, treatment, prognosis and hospital (Required) Strong analysis/problem solving skills. (Required) Skill in the evaluation of quality and appropriateness of care. (Required) Proven leadership ability. Strong organization skills with the ability to work in a fast-paced environment independently or as part of an interdisciplinary team. (Required) Computer skills to include proficiency in keyboarding and data entry. (Required) Critical thinking skills, able to assess, evaluate and teach. (Required) Knowledge of discharge planning, health care reimbursement, utilization review processes and Medicare admission status/classification level. (Required) MS Office proficiency. (Preferred) Department / Location Specific Notes PHSW Care Management: Within the Emergency Department Case Manager role: coordinate alternative level transfers (SNF, ALF, ICF, home health), coordinate equipment and other discharge resources. Five years' acute care experience preferred. Working Conditions Lifting Patient handling no greater than 35 lbs. without the use of assistive equipment and/or devices (NIOSH). Fine motor skills to be able to grasp and control medical equipment and perform precise procedures. Push/Pull: Frequently up to 45 lbs. force (i.e., WOW, medical carts). Perform hands on CPR at least 20 mins using lbs. of force (National Assoc. of EMS Physicians and AHA) Frequency should be seldom or occasionally. Ability to move around area with frequent sitting.Bending/ stooping/ squatting/ reaching/ kneeling frequently. Lifting (non-patient) up to 20 lbs. occasionally and 5 lbs. frequently. Environmental Conditions Exposure to biohazard, body fluids and airborne particles. Must be able to complete tasks in a noisy environment. Mental/Visual Vision and hearing required within normal limits (glasses, contacts, hearing aids permitted). Ability to communicate and exchange accurate information. PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program. See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility ( . For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state, or federal laws. PeaceHealth requires a completed Primary Vaccine Series (e.g., 2 dose monovalent Pfizer, Moderna or Novavax series or 1 dose J&J vaccine series) or be Up to Date (receiving the most recent Pfizer/Moderna bivalent vaccine/booster) for COVID-19 vaccination prior to their start date. PeaceHealth has a medical and religious exemption request process for those that are unable to receive the COVID-19 primary vaccine series due to medical/religious reasons. For caregivers that will be working in Oregon there is a personal vaccine exemption form that may be requested. REQNUMBER: 87433

Created: 2024-11-05