Description:
Inpatient: 8:30-5PM M-F, rotating weekends (could be every other weekend, just dependent on staffing needs) They are making discharge plans, helping with the care plan with the doctors, less busy than ED. - Plans, develops, assesses & evaluates care provided to members. - Collaborates with physicians, other members of the multidisciplinary health care team & patient/family in the development, implementation & documentation of appropriate, individualized plans of care to ensure continuity, quality & appropriate resource use. - Recommends alternative levels of care & ensures compliance with federal, state & local requirements. - Assesses high risk patients in need of post-hospital care planning. - Develops & coordinates the implementation of a discharge plan to meet patient's identified needs. - Communicates the plan to physicians, patient, family/caregivers, staff & appropriate community agencies. - Reviews, monitors, evaluates & coordinates the patient's hospital stay to assure that all appropriate & essential services are delivered timely & efficiently. - Participates in the Bed Huddles & carries out recommendations congruent with the patient's needs. - Coordinates the interdisciplinary approach to providing continuity of care, including Utilization management, Transfer coordination, Discharge planning, & obtaining all authorizations/approvals as needed for outside services for patients/families. - Conducts daily clinical reviews for utilization/quality management activities based on guidelines/standards for patients in a variety of settings, including outpatient, emergency room, inpatient & non-KFH facilities. - Acts as a liaison between in-patient facility & referral facilities/agencies & provides case management to patients referred. - Refers patients to community resources to meet post hospital needs. - Coordinates transfer of patients to appropriate facilities; maintains & provides required documentation. - Adheres to internal & external regulatory & accreditation requirements & compliance guidelines including but not limited to: TJC, DHS, HCFA, CMS, DMHC, NCQA & DOL. - Educates members of the healthcare team concerning their roles & responsibilities in the discharge planning process & appropriate use of resources. - Provides patients with education to assist with their discharge & help them cope with psychological problems related to acute & chronic illness. - Per established protocols, reports any incidence of unusual occurrences related to quality, risk and/or patient safety which are identified during case review or other activities. - Reviews, analyses & identifies utilization patterns & trends, problems or inappropriate utilization of resources & participates in the collection & analysis of data for special studies, projects, planning, or for routine utilization monitoring activities. - Coordinates, participates & or facilitates care planning rounds & patient family conferences as needed. - Participates in committees, teams or other work projects/duties as assigned.
Skills:
Case management, Acute care, discharge planning
Top Skills Details:
Case management,Acute care,discharge planning
Additional Skills & Qualifications:
1 full year of acute case management experience needed recently RN license required BLS from American Health Association required
Experience Level:
Intermediate Level
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