Sinai Health System
RN Case Manager
In collaboration with the patient/family, social workers, physicians and interdisciplinary team, the case manager ensures patient progression through the continuum of care in an efficient and cost effective manner. The case manager is responsible for identifying, initiating and managing optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety and length of stay management. Support and expertise are provided through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. Care coordination and discharge planning are accountabilities of this role. Working closely with bed management, bed capacity issues are addressed in a timely manner and on an ongoing basis. Education is provided to physicians and other members of the team on the issues related to utilization review including appropriateness of admission, level of care and external placements. The Case Manager adheres to departmental and organizational goals, objectives, standards of performance and policies and procedures, continually assuring quality patient care and regulatory compliance.
General Summary/Basic Purpose of Job:
Implementation and coordination of admission / discharge / and transition of care needs under the direction of the Director of Case Management and Physician Advisor.
Essential Functions and Duties:
- In collaboration with the patient/family, physicians and interdisciplinary team, the case manager ensures patient progression through the continuum in an efficient and cost effective manner.
- The case manager is responsible for identifying, initiating and managing optimal patient flow throughput to enhance continuity of care, smooth and safe transitions between levels of care and discharge.
- Performs daily patient rounding on new and existing patients completing the necessary documentation for admission assessment, expected length of stay, readmission risk and transitions to the next level of care.
- Works in tandem with Utilization Management (UM) and Clinical Documentation (CD) to ensure collaboration in medical necessity admissions and continued stay reviews by supporting and communicating UM and CD initiatives.
- Partners with physicians to effectively manage the observation patient in an effort to identify and address any barriers to the next level of care; ensuring a timely discharge.
- Collaborates with other members of the team; the social workers and support staff in the identification and proactive implementation of discharge planning needs on day of patient admission.
- Identifies and activates team members for the high risk patient through the admission assessment and regular reassessments. Engages comprehensive complex case management and / or more extensive discharge planning as defined by the patient’s individual needs.
- Participates in multidisciplinary rounds in an effort facilitate communication within the healthcare team to coordinate the patient’s treatment plan progress and ensures patient/family understanding and engagement in the treatment plan.
- Performs regular review of patient’s physician progress notes/ and clinical interventions to proactively identify delays in patient flow impacting length of stay and acts to change the projectory of identified delay.
- Mobilizes resources, physicians, ancillary providers, and other patient care personnel to achieve desired clinical outcomes and safe transition plans within a timeframe supporting the established length of stay, care transitions, and patient flow.
- Acts as a liaison between providers to optimize communication and facilitates a smooth transition through the inpatient and outpatient healthcare system settings.
- Provides quality outcome measures of post-acute providers to support patient choice upon discharge / transition of care to a post-acute provider.
- Identifies and participates in the development of strategies to reduce unnecessary admissions, LOS, resource consumption, records avoidable delays in an effort to address barriers to the progression of patient care.
- Collaborates with the social worker and supportive staff in coordinating and implementing the discharge plan for high risk patients with post-care needs (i.e. home health, DME, transfers to SNF, etc.).
- Provides timely follow up evaluation and intervention of post discharge services in order to ensure continuity and adequacy of post discharge services.
- Position will ultimately be a system role and may require travel among the campus locations.
- Assumes additional duties as assigned.
Skills and Qualifications:
- Bachelor’s Degree in Nursing or Allied Health field
- 3 years of healthcare case management experience or utilization review.
- Knowledge of Acute Care Criteria and/or M&R Guidelines
- 2-3 years general nursing experience in a hospital setting
- Ability to create and analyze data, perform gap analysis. Proficient in Excel, other Microsoft Office products
- Outstanding oral and written communication skills
- Ability to work independently in accordance with policy and procedure.
If this describes you, then apply today for immediate consideration.
- Self-Scheduling: 12-Hour Shifts – Days, Evenings or Nights
- Institutions: Teaching Hospital, Level 1 Trauma Center (MSH), Level 2 Trauma Center (HCH)
- Paid Time Off (PTO)
- Tuition Reimbursement
- Health Insurance, Short & Long Term Disability, Life & Long Term Care Insurance, Critical Illness & Accident Insurance, Wellness Program
- 403(b) match
- Flexible Spending, Health Savings accounts and voluntary benefits at group rates
- Train Shuttle
- Legal Protection Plan
- Employee Assistance Program (EAP) , Employee Discounts