Registerd Nurse - RN - Maria Parham Health

Maria Parham Health RN-Case Manager

Job Summary

The RN Case Manager is responsible for the coordination of clinical care, quality, and financial outcomes of a designated population of patients. The RN Case Manager is responsible for overseeing an efficient plan that will ensure continuity and effective community or post-acute reentry. The RN Case Manager leads the interdisciplinary team in developing complex discharge plans.
Reports to: Director Case Management
FLSA: Non-exempt
Grade:
EEO: □ 01 Officials and Managers X 02 Professionals □ 03 Technicians □ 04 Sales Workers □ 05 Administrative Support Workers □ 06 Craft Workers □ 07 Operatives □ 08 Laborers and Helpers □ 09 Service Workers

Job Requirements

Minimum Education associate degree in nursing required. Bachelor’s degree in nursing preferred.

Required Skills Licenses: Current/active North Carolina or compact RN license required. AHA Basic Life Support (BLS) required. Case Management Certification, preferred.

Critical thinking skills, decisive judgment, and the ability to organize and prioritize workload to meet deadlines with minimal supervision. Must possess excellent people skills to interact with all levels of healthcare providers, support staff, and third-party payors where appropriate Excellent computer skills Must possess excellent people skills Requires a working knowledge of community resources and Utilization/Quality Review standards and activities conducted by third party payors.

Minimum Work Experience5 years recent acute care hospital experience, required Supervisory experience, preferred Hospital case management experience strongly preferred.

Nonessential Functions
other duties as assigned.

Functional Demands

Populations Served□ Does not treat or care for patients. X Neonate (<30 days) X Infant (<1 year) X Early Childhood (1 year and <5 years) X Late Childhood (5 years and <13 years) X Adolescent (13 and <17 years) X Young Adult (17 to <30 years) X Middle Adult (30 years to <60 years) X Older Adult (>60 years)

Protected Health Information Type of Protected Information Accessed: Demographic Clinical Insurance Financial X Complete Medical Record

Bloodborne Pathogens Exposure While performing this job, occupational exposure is present for all employees.

Physical Requirements - Physical Dexterity and Effort: Rarely <1%, Occasionally 1-33%, Frequently 34-66%, Constantly 67-100%Bending/Stooping X rarely, □ occasionally, □ frequently, constantly Climbing X rarely, □ occasionally, □ frequently, □ constantly Keyboard Data Entry □ rarely, □ occasionally, X frequently, □ constantly Kneeling X rarely, □ occasionally, frequently, □ constantly Lifting/Moving Patients □ rarely, X occasionally, frequently, □ constantly Reaching □ rarely, □ occasionally, X frequently, □ constantly Repetitive Foot/Leg Movements □ rarely, □ occasionally, X frequently, □ constantly Repetitive Hand/Arm Movements □ rarely, □ occasionally, X frequently, □ constantly Running X rarely, □ occasionally, □ frequently, □ constantly Sitting □ rarely, X occasionally, □ frequently, □ constantly Squatting □ rarely, X occasionally, □ frequently, □ constantly Standing □ rarely, □ occasionally, X frequently, □ constantly Walking □ rarely, □ occasionally, X frequently, □ constantly Pushing / Pulling: 0-25 lbs. □ rarely, □ occasionally, X frequently, □ constantly Pushing / Pulling: 26-75 lbs. □ rarely, □ occasionally, X frequently, □ constantly Pushing/Pulling: over 75 lbs. □ rarely, □ occasionally, X frequently, □ constantly Lifting/Carrying (non-patient) : 0-25 lbs. □ rarely, □ occasionally, X frequently, □ constantly Lifting/Carrying (non-patient) : 26-75 lbs. □ rarely, X occasionally, □ frequently, □ constantly Lifting/Carrying (non-patient) : over 75 lbs. X rarely, □ occasionally, □ frequently, □ constantly

Visual Acuity, Hearing and Speaking: Rarely <1%, Occasionally 1-33%, Frequently 34-66%, Constantly 67-100%Audible Speech □ rarely, □ occasionally, □ frequently, X constantly Hearing Acuity □ rarely, □ occasionally, □ frequently, X constantly Smelling Acuity X rarely, □ occasionally, □ frequently, □ constantly Taste Discrimination X rarely, □ occasionally, □ frequently, □ constantly Vision: Depth Perception □ rarely, □ occasionally, X frequently, □ constantly Vision: Distinguish Color □ rarely, □ occasionally, X frequently, □ constantly Vision: Seeing Far □ rarely, X occasionally, □ frequently, □ constantly Vision: Seeing Near □ rarely, □ occasionally, □ frequently, X constantly

Biological: Rarely <1%, Occasionally 1-33%, Frequently 34-66%, Constantly 67-100%Biohazardous waste/ hazards □ rarely, X occasionally, □ frequently, □ constantly Blood and/or bodily fluids □ rarely, □ occasionally, X frequently, □ constantly Communicable diseases/pathogens □ rarely, X occasionally, □ frequently, □ constantly

Chemical: Rarely <1%, Occasionally 1-33%, Frequently 34-66%, Constantly 67-100%Asbestos or lead X rarely, □ occasionally, □ frequently, □ constantly Cytotoxic Chemicals X rarely, □ occasionally, □ frequently, □ constantly Dust X rarely, □ occasionally, □ frequently, □ constantly Hazardous Chemicals □ rarely, X occasionally, □ frequently, □ constantly Gases/Vapors/Fumes □ rarely, X occasionally, □ frequently, □ constantly Hazardous Medication □ rarely, X occasionally, □ frequently, □ constantly Latex □ rarely, □ occasionally, X frequently, □ constantly

Organizational Expectations

Maria Parham Health is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual’s age, color, disability, genetic information, gender, gender identity, national origin, race, religion, sexual orientation, or veteran status.

Provides a positive and professional representation of the organization.

Promotes a culture of safety for patients and employees through proper identification, reporting, documentation, and prevention.

Maintains hospital and clinic standards for a clean and quiet patient environment to maintain a positive patient care experience.

Maintains competency and knowledge of current standards of practice, trends, and developments in related scope of role or practice.

Maintains compliance with organization's policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards.

Complies with organizational and regulatory policies for handling confidential patient information.

Demonstrates excellent customer service through his/her attitude and actions, consistent with the standards contained in the Vision, Mission, and Values of the organization.

Adheres to professional standards, hospital policies and procedures, federal, state, and local requirements, and TJC standards and/or standards from other accrediting bodies.

Essential Functions

Facilitates patients care plan as called for in the plan of care

Leads daily discussions regarding patients regarding patients’ progression along the continuum

Works collaboratively as a leading member of the health team to ensure appropriate use of hospital resources, patient satisfaction, and achievement of quality of care, manages input from all healthcare professionals and conducts assessments to determine patient’s healthcare and transitional needs

Evaluates and ensures appropriateness of admissions and continued stay using evidence-based criteria.

Collaborates and manages outcomes with the payers through ongoing written and verbal communications through appropriate parties.

Leads discussions with MDs and physician advisors about safe plan for transitions.

Leads the team to ensue appropriate utilization of patient and hospital resources and directs care to other settings when appropriate.

Collaborates with community case managers and other health care advisors to ensure a smooth and safe continuum of care plan.

Conducts extensive assessments and implements interventions for patients at risk for readmissions.

Manages concurrent denials and works with physicians to overturn for appropriate reimbursement.

Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran