Overview RN Registered Nurse Case Manager (25009142)
Schedule: Full-time 40 hours/week Monday-Friday; Start times flexible – 8a/8:30a/9a; 8-hour shifts; Rotating weekends and holidays
Location: UChicago Medicine AdventHealth Hinsdale Hospital, 120 N Oak Street, Hinsdale, IL 60521
The role you’ll contribute The RN Care Manager, in collaboration with the patient/family, social workers, nurses, physicians and the interdisciplinary team, ensures patient-centered care coordination and progression through the continuum of care. The RN Care Manager ensures efficient and cost-effective care through appropriate resources monitoring and clinical care escalations. The RN Care Manager is responsible for patient evaluations of post-hospital needs; development of a transition of care plan and initiation of implementation prior to discharge. The RN Care Manager supports optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety, readmission prevention and length of stay management. The RN Care Manager communicates daily with the interdisciplinary team during daily multidisciplinary rounds. Core competencies include care coordination, discharge planning, transitions of care planning and understanding of medical necessity. The RN Care Manager facilitates the collaborative management of patient care across the continuum, intervening to remove barriers to timely and efficient care delivery and reimbursement. The RN Care Manager provides education to nurses, physicians and the interdisciplinary team on utilization of resources, CMS CoP for Discharge Planning and care coordination. The RN Care Manager is knowledgeable of post-hospital care and services including Home Health, Infusion Services, Durable Medical Equipment, Palliative Care, Hospice, Outpatient Services, Transitions of Care Clinics, Transitional Care programs, follow up appointments, Skilled Nursing Facilities, Rehabilitation Services and Community-based Organizations. The RN Care Manager adheres to departmental and system goals, policies and procedures and ensures quality patient care and regulatory compliance. Actively participates in outstanding customer service and maintains respectful relationships.
Value to the team Completes Initial Evaluation for transition of care needs on all identified patients within one calendar day of admission and documents according to policies and procedures. Interviews patient and involved caregivers (as permitted by the patient) and reviews the current and past inpatient and outpatient medical records in the Initial Evaluation.
Reviews necessary patient information including labs, medications (pre and post hospital), History and Physical, Therapy notes, ED notes, test results and progress notes.
Incorporates patient/family care goals and preferences into the transition of care planning and communicates these goals to the multidisciplinary team.
Incorporates clinical, social and financial factors into the transition of care plan.
Meets with patient/families to discuss realistic and appropriate discharge options and providers of post-hospital care.
Incorporates social determinants of health into transitions of care planning and applies risk mitigation interventions to meet individual patient needs.
Qualifications The expertise and experiences you’ll need to succeed:
EDUCATION AND EXPERIENCE REQUIRED:
Associate’s degree in nursing or RN diploma
1+ years of RN experience
EDUCATION AND EXPERIENCE PREFERRED:
Health-related Master’s degree or MSN
LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:
State of Illinois registered nurse license
LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:
Not specified
Organization Organization: UChicago Medicine AdventHealth Great Lakes