Registered Nurse (RN) Emergency Department Case Manager Aurora Health Care – Registered Nurse (RN) Emergency Department Case Manager
Overview Responsibilities, qualifications and details for the role as listed.
Major Responsibilities Conducts complete assessments, establishes appropriate plans, and initiates interventions within desired timeframes.
Collaborates and negotiates effectively with patient, family, and team while striving to achieve patient and organizational goals with regard to patient’s care needs, choice and satisfaction when discharge planning/transitioning care.
Utilizes patient/family strengths in the problem-solving process, involving the patient/family and team in the decision-making process beginning on admission and continuing throughout patient’s hospital stay.
Provides continuity of care and discharge planning services compliant with regulatory standards by providing coordinated relevant options and services based on assessed needs to ensure patient/family and healthcare team is informed and able to proceed with accountabilities in a timely manner.
Participates in the communication process to facilitate a smooth transition for patient, family, and staff when patients are transferred.
Provides case management services related to various levels of health care, finances, housing, family discord, or illness adjustment, based on department scope.
Initiates internal and external referrals to assure timely progression of care and transitions; documents discharge planning interventions and utilization review activity per department standards.
Performs and documents concurrent and retrospective reviews based on approved criteria as required by department standards.
Communicates effectively with the healthcare team; works with Social Work and unlicensed support personnel to establish and implement a safe plan of care.
Serves as an active member of the Outcome Facilitation Team/Patient Care Multidisciplinary Team and collaborates with medical staff, hospital departments and ancillary services to identify and resolve barriers to discharge and expedite care delivery.
Collaborates with managers, physicians, medical directors, advisory groups, and treatment teams to align with physician practices and best practices for the patient’s plan of care.
Remains knowledgeable about healthcare regulations, reimbursement issues, impact on length of stay and community resources; completes UM activities and provides clinical updates to payers and external review organizations as required.
Develops and maintains productive relationships with community-based agencies and networks; represents Advocate Aurora Health Care positively in internal and external collaborations.
Serves as an educator and expert resource to medical and hospital staff regarding admission status, utilization management issues, care coordination and discharge planning needs, and regulatory requirements.
Qualifications License/Registration/Certification: Registered Nurse License issued by the state of practice.
Education: Bachelor’s Degree in Nursing.
Experience: 2 years of clinical nursing experience.
Knowledge, Skills, and Abilities: Ability to prioritize and organize work; effective communication; critical thinking and timely decision making; ability to navigate the Electronic Health Record; basic MS Office; knowledge of Medicare Parts A and B guidelines; knowledge of Managed Care program requirements; ability to apply elements of Utilization Management programs.
Physical Requirements: Sit up to 50% of the workday; stand/walk as needed; lift up to 10 lbs continuously, up to 20 lbs frequently, up to 50 lbs occasionally; manual dexterity; visual and verbal communication abilities; able to operate required equipment.
Employment details Employment type: Full-time
Job function: Other
Industries: Hospitals and Health Care
Base pay range: $37.50/hr - $56.25/hr
Location Milwaukee, WI
Note: This job description reflects the general nature and level of work expected; it is not a comprehensive listing of activities, duties, or responsibilities. Incumbent may be required to perform other related duties.