Case Manager (RN)- ED

Employee Type

Regular

Work Shift

Evening - 8 hour shift (United States of America)

Join Team Tidelands and help people live better lives through better health!

Position Summary: Uses ED tracking system, medical record, and demographic information to identify patients needing CM intervention. Gathers sufficient information from and communicates with all relevant sources to facilitate appropriate discharge from ED to appropriate level of care to assure it is done in an accurate, safe, timely and cost-effective manner to prevent readmission and/or frequent visits to ED. Identifies and facilitates resolution of clinical and operational roadblocks to achieve optimal outcomes by identifying alternatives as needed. Documents all care management assessments and interventions. Acts as a resource to ED staff and physicians (ED and hospitalists) regarding appropriateness of admission, levels of care (including related documentation requirements and observation vs. inpatient requirements). Performs pre-admission review of patients that are being worked up for admission. Resolves issues of incorrect status through discussions with ED and Admitting Physicians by obtaining additional information to support admission order or determine alternative level of care. Coordinates discharges home from the ED and facilitate transfers to external placement facilities and/or community resources/services as appropriate. The RN Case Manager will maintain expert knowledge of InterQual Level of Care criteria. Escalates to physician advisor when unable to resolve issues with the attending physician, according to policy and timeframes established. Complies with regulations, standards and legislation (local, state and federal) related to the continuum of care and patient transition. The ED Case Manager will complete other duties/task as assigned.

Job Objective:

The position is responsible for facilitating the patient's level of care from preadmission through discharge from the Emergency Department to the community or to an alternative level of care. The case manager interfaces with physicians, nurses, and other healthcare team members to expedite medically appropriate, cost-effective care. The position proactively identifies potential patient admissions and patients with needs for discharge to appropriate community resources. The position works with physicians to identify appropriate patient status for admission to the acute care hospital (inpatient versus observation).

Qualifications

Education:

• Associates Degree in Nursing required

• Current and in good standing SC RN license with SCLLR.

Experience:

• Minimum two years RN Case Management experience in acute health care delivery setting preferred.

• Demonstrates knowledge and experience with Case Management and outcomes required.

• Knowledge in acute care level psychosocial intervention and practices required.

• Experience with Epic preferred.

Knowledge/Skills/Abilities:

• Able to work independently, adjust priorities often and establish rapport quickly required.

• Exceptional critical thinking and problem-solving skills required.

• Acts as a resource to Emergency Room staff and physicians regarding appropriateness of admission, levels of care (including related documentation requirements and observation vs. inpatient requirements), quality of care concerns and criteria/guidelines/protocols utilized in care planning and resource utilization.

• Proven communication skills, both verbal and written required.

• Expertise in facilitation of complex family and patient placement outcomes required.

• Knowledge of community resources and service eligibility required.

• Basic computer knowledge and skills required to manage multiple databases are required.

• A primary home base will be established but flexibility to float to various facilities within the Tidelands Health system as may be needed required.

Physical Requirements : Light Physical Agility Test (PAT) Rating

While performing the duties of this job, the employee is frequently (activity or condition exists from 1/3 to 2/3 of the time) required to stand, sit, and walk; frequently to use hands, fingers; and frequently to talk or hear. The employee must exert up to 15 pounds of force occasionally (activity or condition exists up to 1/3 of the time), and/or up to 5 pounds of force frequently, and/or a negligible amount of force constantly to move objects.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Tidelands Health is an equal opportunity employer (EOE). Tidelands Health does not discriminate against employees or applicants for employment on the basis of race, color, creed, religion, age, national origin, disability, marital status, veteran status, gender, genetic information, familial status, or any other legally protected status.