Registered Nurse (RN) Case Manager Lead - Case Management
Provides education and oversight for case management processes, technology and standard work. Collaborates and serves as an expert resource for case managers and other clinical departments.
Supports case managers on a daily basis, keeping abreast of difficult/complex cases, and coaching, guiding, and assisting as necessary.
Provides assistance/support with direct patient care issues - removes barriers for discharges, trouble shoots/ problem solves with case managers regarding DME /MD/family issues etc.
Provides analysis and feedback on process improvement activities, develops and presents focused educational programs for staff, both individually and in group settings.
Partners with leadership team on community and hospital wide initiatives focused on reducing length of stay and increasing safe discharges.
Collaborates in ongoing re-design and re-engineering of Case Management functions, to meet the changing needs and priorities of the organization as well as Medicare Conditions of Participation.
Ensures case manager compliance with state, federal, and contract payer rules, including Medicare Conditions of Participation.
Attends, directs as needed and follows up on issues from care coordination rounds with case managers and/or Physicians.
Participates in daily flow meetings, to provide feedback, assess need for resources based on throughput and speak to patient, physician or case management barriers to discharge.
Maintains confidentiality and protect sensitive data at all times, including patient information, proprietary information, and personnel information.
Provides guidance/support to department on-boarding committee regarding the training needs of new RN case managers.
Adhere to TMC organizational and department-specific safety, confidentiality, values, policies and standards.
Perform related duties as assigned.
EDUCATION: Bachelor’s degree in Nursing from a qualified, nationally-accredited nursing program (may substitute a Bachelor’s degree in a related healthcare field plus relevant experience).
EXPERIENCE: Three (3) years of RN experience, and two (2) years experience in Utilization Review (UR), Case Management, or related area; preferred leadership or management experience.
LICENSURE OR CERTIFICATION: Current RN licensure permitting work in State of Arizona, and Basic Life Support (BLS) certification.
KNOWLEDGE, SKILLS AND ABILITIES:
Thorough clinical knowledge of disease process.
Knowledge of relevant laws, regulations, and safety requirements and standards.
Knowledge of case management procedures and techniques, tools, and responses required to ensure optimal patient care.
Skilled in communicating in a clear and concise manner with staff and physicians to ensure the proper pathway of care for patients.
Skill in evaluating cases and determining appropriate care and status.
Ability to read, analyze, and interpret hospital charts and to communicate effectively with hospital staff.
Ability to generate, analyze, assess, and use organizational data to educate other professionals and improve and implement case management processes.
Ability to develop and meet department and organizational goals.
Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.