Case Manager RN - Care Coordination

Requisition ID
2021-148980
Employment Type
Full Time
Department
Care Coordination
Hours / Pay Period
80
Shift
Day
Standard Hours
8:00 - 4:30
Facility / Process Level : Name
MercyOne West Des Moines
Location
IA-WEST DES MOINES

Overview

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. & from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Responsibilities

GENERAL SUMMARY:

Develops, coordinates and oversees the implementation of patient specific plan of care.  Works collaboratively with physicians, staff, and other health care professionals/agencies to negotiate care coordination across the health care continuum for disease specific populations.  Communicates feedback about progress towards client goals with appropriate individual/groups at specific intervals.  Collaborates with other services and disciplines, and when appropriate, the client’s medical physician and/or related health care professionals/agencies to enhance a holistic approach to patient care.  Ensures safety, best practice, and high quality standards of care are maintained across the continuum.  Is accountable for Care Management evaluation including: data capture and analysis, outcome achievement, and fiscal responsibility in an effort to improve service, quality and cost provided to the clients served. 

 

 

 

ESSENTIAL FUNCTIONS:

  • Completes a comprehensive assessment of the client’s holistic health status and needs to include clinical condition, support systems and resources, client/family knowledge, perception and adjustment towards disease process, and community resources.
  • Screens patients/clients for identified and potential needs. Makes referral to appropriate multi-disciplinary services.
  • Documents case management plan to include: assessment, client/family participation and understanding, consult referrals and discharge plan of care.
  • Educates staff, clients/families, and medical community on care coordination and regulatory issues that impact care and outcomes.
  • Documents clearly and timely in the Electronic Health Record and other required systems to insure effective communications along the continuum.
  • Collaborates with Utilization Management staff regarding payer information, level of care and status determinations for patients.
  • Understands and self manages to support facility/CIN level success goals; including improvements in quality, cost of care and member experience for the facility/CIN’s population.
  • Identifies opportunities for improvement (at individual, facility/CIN levels and actively works with healthcare and facility/CIN team to correct or improve results.
  • Develops and utilizes tools available to effectively evaluate, summarize and communicate patient’s progress toward outcomes to members of the healthcare team and patient and family.
  • Has a working knowledge of financial and reimbursement processes Medicare DRG payment, Case Rates, Managed Care Risk Contracting, etc.
  • Coordinates and conducts patient care rounds and family conferences.
  • Collaborates with Unit Director in strategies/tactics to achieve unit based goals such as quality, financial, and safety indicators.
  • Demonstrates a wide theory/research base that supports sound clinical and psychological orientation. Specific knowledge regarding pathophysiology, natural history of disease processes, and impact on functional ability and level of care.
  • Serves as a professional role model/mentor and change agent to develop and assist others.
  • Other duties as assigned by CIN Director/Care Management/Social Services Manager.

Qualifications

MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:

  • Possession of a current or compact state license as a Registered Nurse issued/defined by the State of Iowa
  • Three years RN or Care Coordination experience, required.
  • Bachelor’s degree in nursing or actively pursuing (at least six credits per year).  A Bachelor’s degree in a related field is also acceptable. .
  • Proof of completion of Mandatory Reporter abuse training specific to population served within three (3) months of hire.

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