RN Case Manager, Clinical Case Management, Part Time, First Shift

The Case Manager utilizes advanced nursing skills and knowledge of resource
management and fiscal responsibility to coordinate the clinical care for a
designated patient population across the continuum of care. The responsibilities
include but are not limited to clinical effectiveness, discharge planning, care
coordination, and clinical resource management. The Case Manager interacts with
Medical, Nursing and Ancillary department staff to facilitate quality based,
cost effective patient outcomes and ensure care is provided in the most
appropriate setting.

RESPONSIBILITIES

PATIENT POPULATION - (CLINICAL ONLY)

* Engages in population appropriate communication.
* Has knowledge of growth and development milestones and tasks.
* Gives clear instructions to patients/family regarding treatment.
* Involves family/guardian in the assessment, initial treatment and continuing
care of the patient.
* Identifies any physical limitations of the patient and deploys intervention
when necessary.
* Recognizes and responds appropriately to patients/families with behavioral
health problems.
* Interprets population related data and plans care appropriately.
* Identifies and responds appropriately to different needs resulting from,
unique psychological needs or those associated with religious / cultural
norms. Performs treatments, administers medication or operates equipment
safely.
* Recognizes and responds to signs/symptoms of abuse or neglect.

Transition of Care Planning

* Collaborate with health care team on the plan of care, referrals and ongoing
needs of the patient. Facilitate communication and coordination of the plan
of care with the residents/attending physicians. Communication is concurrent
and proactive. Goal is to increase quality, efficiency and patient
satisfaction while managing LOS for targeted population.
* Review and assess selected cases within one business day of admission and as
appropriate throughout the patient’s stay to assess and execute transition of
care planning requirements that ensure timely and appropriate discharges.
* Perform face-to-face brief screen on appropriate patients within one business
day of admission to determine discharge barriers early in hospital
stay/document findings in MR Progress Notes.
* Work to improve quality through reduction in treatment delays. Facilitate
timely tests/procedures; obtains lab results; as needed, discusses the
implications for discharge with nursing staff and residents. Evaluates with
the team, the patient’s response to pharmacological and therapeutic treatment
regimens. Collaborates in the preparation of discharge forms/paperwork and
prescriptions that often delay the discharge.
* Identify actual and potential delays in service and works with the
appropriate individuals, including but not limited to, the patient, family,
caregivers, Access Team, Social Work, Financial Counseling, and Quality
Management Services to ensure timely action/resolution.
* Participate in daily Care Coordination Rounds
* Coordinate patient care conferences based on patient/family needs.
* Work with multidisciplinary staff to ensure patient/family has received
appropriate information and education prior to transition to the next level
of care.
* Identify and solve problems related to discharge needs, implement a plan of
care and co-ordinate a safe and timely discharge.
* Identify and arrange for provision of skilled home care (nursing, PT/OT,
Dietician, SW, etc.) medical equipment and supplies needed for home care
services.
* Coordinate the preparation, delivery and scheduling of infusions, enterals
and treatments with patient’s hospital care providers and patient’s discharge
time.
* Collaborate with home care providers for benefits and coverage of home care
services.
* Advocate, mediate and negotiate to formulate a cohesive plan for maintaining
or enhancing patient’s health status and moving the patient safely to the
home or next level of care.
* Provide ongoing consultation and training to medical staff and other
healthcare professionals on discharge and home care issues; participate in
process improvement activities; identify barriers in service delivery systems
and develop a process for improvement.
* Collaborate with the health care team to identify resources available for the
patient/family; provides, either directly or through referral. Coordinate the
provision of education for patient and family regarding the plan of care and
health care needs.
* Help develop, revise and evaluate tools needed to facilitate care
coordination and patient care standards.
* Participate in process improvement and evaluation of patient outcomes for
specific patient populations. Participate with in quality improvement
activities.
* Collect data on clinical resource management, LOS, readmission less than 30
days as well as other data on identified patient outcomes.
* Utilize Allscripts/ECIN according to department standards to make discharge
planning arrangements and document interventions.
* Provide post discharge phone call to patients discharged with home care/DME
to confirm success of after care arrangements

Utilization Review

* Review assigned patient population to ensure that admissions, continued stays
and ancillary services are medically necessary and provided in the
appropriate setting.
* Using the Allscripts/ECIN® work list, determine daily work assignment and
perform concurrent chart review.
* Evaluate initial level of care and patient type for all patients to ensure
appropriate use of facility resources.
* Discuss admission criteria and expected LOS with care team.
* Interact with Resident and Attending Physicians as needed to ascertain
certain clinical findings to support SI/IS criteria, length of stay and
patient care guidelines and assures appropriate documentation.
* When appropriate, escalate cases to Clinical Manager for review and
allocation of appropriate resources, including but not limited to,
consultation with Nursing Leadership, Hospital Administration and Physicians
leaders.

Miscellaneous

* Support various quality initiatives under the direction of department
leadership.
* Demonstrate customer focused interpersonal skills, utilizing problem solving
process and critical thinking.
* Communicate and resolve conflict with physicians, health care team members,
community agencies, clients and families with diverse opinions, values and
religious/cultural ideas.
* Perform other duties as assigned; for example, participation in planning
sessions for departmental activities.

Professional Development

* Attend appropriate clinical and professional organizations, workshops and
meetings.
* Stay abreast of community resources available to facilitate safe patient
transitions of care.
* Remain current on clinical advancements related to primary patient
population.
* Proactively seeks to understand areas/roles outside of immediate area/role
within department.

QUALIFICATIONS

* Registered Nurse from an accredited school of Nursing, College or University
required. Bachelor of Science in Nursing (BSN) preferred. 
* Current RN License in Ohio. Certification in Case Management or Certified
Professional in Health care Quality (CPHQ) encouraged. 
* Three years Home Health, Discharge Planning, and / or Case Management
experience.

At UC Health, we're proud to have the best and brightest teams and clinicians
collaborating toward our common purpose: to advance healing and reduce
suffering.

As the region's adult academic health system, we strive for innovation and
provide world-class care for not only our community, but patients from all over
the world. Join our team and you'll be able to develop your skills, grow your
career, build relationships with your peers and patients, and help us be a
source of hope for our friends and neighbors.

UC Health is an EEO employer.