Registered Nurse (RN) Care Manager - The Jewish Hospital

Job

Summary

The RN Care Manager is responsible for providing coordination of care for patients to support safe, seamless, timely transitions across the continuum. This role utilizes a collaborative process, the RN Care Manager identifies (using quantitative and qualitative methods), assesses, plans, implements and evaluates the options and services required to meet an individual’s health and health related needs, including social- determinants that affect ones’ overall wellbeing. The RN Care Manager is responsible for screening, identification, and assessment of individuals in need of active Case Management services and promotes the right resources, at the right time and at the right place.

Essential Functions

Identifies and prioritizes patients in need of care management services, using a holistic approach inclusive of biopsychosocial, functional, cultural, spiritual, and financial factors. Plans with the patient, caregivers and members of the healthcare team to maximize health care responses, quality and cost-effective outcomes. Monitors and revises the plan as indicated when patient condition changes.

Completes all necessary documentation. Maintains, clear, concise, and timely documentation in the patient record to reflect the needs of the patients. Handovers are expected to be utilized at points of level of care change, staff change, as well as care transitions.

Documentation will reflect plan of care to address post hospital care needs and resources and evidence of patient, family or caregiver involvement in planning. Ensuring patient’s and caregiver’s treatment goals and preferences are incorporated into the transition of care planning and communicated to the multidisciplinary team.

Follow standardized practices and process related to Advance Care Planning, Length of Stay management and readmission prevention.

Supports denial prevention related to medical necessity through addressing / removing barriers to progression of care and participating in Interdisciplinary Discharge Rounds.

Supports and promotes assertive, proactive care for patients, assisting in removing barriers related to achieving timely testing and treatment. Ensures resources are utilized appropriately and offering alternatives to acute care to the care team.

Education

Bachelor of Science in Nursing (preferred for BSMH, required for RSFH)

Licensure/

Certification

BLS Basic Life Support – American Heart Association (required)

RN License in the state in which they are working or covered by compact (required)

Accredited Case Manager Certification (ACM) from American Case Management Association or Certified Case Manager (CCM) from Commission for Case Manager Certification or American Nurses Credentialing Center (ANCC) Nursing Case Management board certification (preferred)

Experience

1 year of experience in clinical setting (required)

3 years of experience in an acute care clinical setting (preferred)

Ambulatory or post-acute, care coordination experience (preferred)

Training

None

Skills and Abilities

Hard/Tech/Clinical

Skills

Care management Discharge planning Patient Advocacy Flexible Care Planning Care Coordination Analyzing data or information Reimbursement methodologies Staffing workflow and bed allocation Clinical knowledge Tracking Working knowledge of local and state resources Knowledge of government and non-government payor practices, regulations, standards and reimbursement

Soft/Interpersonal

Skills

• Knowledge Sharing
• Attention to detail
• Critical thinking
• Communication with family members
• Conflict resolution
• Proactive
• Problem Solving
• Active listening
• Relationship building
• Effective problem solving
• Teamwork
• Facilitation

As a Mercy Health associate, you're part of a Mission that matters. We support your well-being—personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.

What we offer

Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible) Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders Tuition assistance, professional development and continuing education support

Benefits may vary based on the market and employment status.

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com