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NON-CERTIFIED RN CASE MANAGER

Bozeman Health
Bozeman

Job Description

Ability to work weekends

Manage needs assessment, planning facilitation, and advocacy for options and services in order to meet customer health care needs through collaboration and communication, as well as, promote quality and cost effective outcomes. Coordinate care from admission through discharge achieving optimal patient outcomes. Provide discharge planning and resource referral based on the needs and assessment of the client. Support family members to assist them in understanding, dealing with, and supporting the patient. Actively involved in professional growth and promotion of case management roles and values. Performs utilization review and assignment of status based on specified criteria. Verifies medical necessity of patient admissions and continued stay. Initiates and maintains positive relationships with patients, customers and coworkers. Takes responsibility for self-development and supports a learning environment. Displays commitment to the mission of the hospital and its values.

REQUIREMENTS

EDUCATION

Required:

Registered Nurse

Preferred:

Bachelors in Nursing

LICENSURE and CERTIFICATION

Required:

Current Montana RN License
CPR certified
Certification in Case Management

Preferred:

EXPERIENCE

Required:

2-5 years of nursing experience

Preferred:

2-5 years experience in an acute care hospital
Previous Case Management

ESSENTIAL FUNCTIONS
30% Time Spent - Clinical Management: Confer with physician to confirm appropriateness of patient's admission and continued stay in acute care environment
Confirm doctor's treatment plan and intended goals with patient and family
Encourage interventions appropriate to the reason for patient's admission
Serve as patient advocate
Initiate referrals to the appropriate areas to expedite care, treatment, and services
Utilize evidence-based clinical protocols when warranted by patient's diagnosis
Seek input from clinical experts to explore acceptable alternatives to treatment plan
Convene and conduct interdisciplinary conferences to solicit input concerning the patient's treatment/discharge plan from clinical team members
Collaborate with physician, patient, family members, and nurses to identify probable post-acute needs
Coordinates all care of the high risk patient from admission through discharge
Facilitates communication among team members

25% Time Spent - Resource Management: Ensure consistent data capture to identify trends/problems related to delivery-of-care delays, avoidable days, and non-acute contributory inpatient testing
Issue Medicare HINN/ABN letters to patients when deemed necessary
Provide clinical information to private payers per utilization review guidelines
Assign patient status based on InterQual criteria in collaboration with physician
Intervene with ancillary department leadership when timely service is critical to patient's immediate needs
Identifies patients needing assistance from the Good Sam account

20% Time Spent - Transition Planning: Confer with health team members to identify patients in need of intensive post-acute services
Confirm probable post-acute needs through supplemental assessment
Collaborate with patient, family, physician, and team members to develop a transition plan appropriate to the patient's needs and financial capabilities.
Determine patient's eligibility for post-acute services within 24 hours of inpatient admission
Ensure that discharge plan implementation activities are conducted to effect a safe and timely transition to the community
Serve as consultant and educator to patient and family
Collaborate with payer representatives to advocate for patient's acute care and post-acute needs
Locate appropriate community resources consistent with benefit eligibility
Serve as liaison to community needs

20% Time Spent - Medical Documentation: Support concurrent coding and documentation improvement
Counsel and inform doctors of the dimensions of accurate documentation
Encourage medical documentation of deviations for protocols
Document all discharge plans and utilization review information in medical record

Additional Stroke Competency (if employee works acute care setting):
Complies with hospital policies, procedures, protocols, and guidelines related to care for patients with hyperacute and acute stroke.
Participates in two hours of initial cerebrovascular disease (stroke) education by November 1, 2018, or within one year of hire.
Participates in one hour annually of cerebrovascular disease (stroke) education.

Employment Type

Casual Call (Per Diem/As Needed)

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