Wooster Community Hospital Job Description

RN Case Manager/Inpatient

MAIN FUNCTION:

Supports the physician and interdisciplinary team in facilitating patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care. Integrates and coordinates utilization management, care facilitation and discharge planning functions. Applies approved clinical appropriateness criteria to monitor appropriateness of admissions and continued stays, documenting findings based on department standards. Identifies at-risk populations using approved screening tools and follows established reporting procedures. Monitors LOS and ancillary resource use, intervening as appropriate. Coordinates/facilitates patient care progression throughout the continuum. Works collaboratively and maintains active communication in a team setting with physicians, nursing and other members of the multi-disciplinary care team to effect timely, appropriate patient management. Stays current with regulations which impact the care of patients and WCH’s regulatory compliance. Promotes individual professional growth and development and meets mandatory/continuing education. The case manager must be knowledgeable of community resources and alternative care facilities. This position must be able to handle multiple priorities and be self-directed. It requires good organizational skills and analytical thinking.

RESPONSIBLE TO: Manager, Integrated Case Management and CDI

MUST HAVE REQUIREMENTS:

Possess an active unrestricted Ohio license.

BSN

5-years of experience in an acute care setting.

No written disciplinary action with the last 12 months.

COMPLEXITY OF WORK:

Requires critical thinking skills, decisive judgment and ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.

PREFERRED ATTRIBUTES:

Critical care experience

Knowledge of discharge processes and resource utilization.

Case management experience in an acute care setting

Certification in Case Management through ACMA

OTHER REQUIREMENTS:

Employee in this position may be exposed to blood, body fluids and/or airborne pathogens and is required to wear barriers. .

Follows Appropriate Service Standards

______________________________________________________________________________

POSITION EXPECTATIONS:

• Performs all aspects of Case Management, including care coordination, discharge planning and resource management.
• Determines appropriate level of care based on the intensity of effort required to diagnose, treat, preserve or maintain the patient’s physical or emotional state.
• Verifies that all inappropriate admissions, unnecessary continued days, and procedures not meeting approved indications are reviewed and discussed with the attending physician.
• Identifies delays in care or services and reports the findings to the appropriate department manager or attending physician.
• Interviews patients, patient representatives, and/or patients’ family/friends when appropriate; meets their psychosocial needs within the scope of authority and established procedures and protocols.
• Collaborates with patient/patient representative, patient caregiver, social worker, and multidisciplinary team to determine discharge plan for patients.
• Participates in multidisciplinary rounds working with the team to organize, secure, integrate and modify the resources necessary to ensure the patient is getting the right treatment in the right place at the right time.
• Participates in daily huddles to review LOS concerns, contributing knowledgeable to the discussion and enacting follow up recommendations
• Communicates with medical staff, hospital personnel, and post-acute providers to provide continuum of care to all patients.
• Initiates the discharge plan for patients of all ages and coordinates and arranges services needed by the patient post-discharge in collaboration with the discharge planning assistant.
• Regularly evaluates the need for continued hospitalization and for necessary changes in the discharge plan with subsequent documentation of such.
• Makes recommendations for changes in the department’s policies, procedures and protocols.
• Anticipates and reports potential problems to appropriate personnel.
• Monitors appropriateness of admissions and continued stay to specialty areas (Telemetry, ICU).
• Ensures completion of daily work assignments by prioritizing and reassigning duties.