Case Manager RN Per Diem

About This Role

The Case Manager RN partners with the interdisciplinary care team to facilitate efficient, high-quality care for hospitalized patients, focusing on appropriate resource utilization and a safe, timely discharge. This role ensures effective transitions and adherence to healthcare industry compliance, driving throughput metrics and fiscal responsibility.

Responsibilities

• Screen all patients early in hospitalization to identify post-acute needs, establish anticipated length of stay, and plan transitions.
• Collaborate with the medical team to formulate treatment plans and promote patient flow.
• Complete initial assessments of all admissions/observation patients to identify barriers impacting length of stay and discharge planning.
• Navigate the care delivery system, ensuring tests, treatments, consults, and procedures are appropriately indicated and performed timely.
• Articulate the plan of care and communicate to the care team, patient, and caregiver, intervening to maintain care progression if deviations occur.
• Create and coordinate the overall transition plan of care based on assessments and concurrent collaboration with various internal and external stakeholders.
• Facilitate daily Multi-Disciplinary Rounds (MDRs), incorporating evidence-based milestones and communicating the plan to the healthcare team.
• Apprise the interdisciplinary team of estimated length of stay, care progression barriers, and anticipated disposition, identifying necessary team contributions.
• Facilitate smooth care transitions by arranging appropriate clinical follow-up and initiating referrals to proper post-acute providers.
• Communicate the plan effectively with the patient and family/caregiver, ensuring they have resources for post-discharge success.
• Proactively interface with payers to verify coverage/benefits and obtain authorization for post-acute care.
• Identify patients at high risk for unplanned readmissions and initiate appropriate interventions, engaging community resources as necessary.
• Document avoidable days, case management assessments, and care plans thoroughly and timely.
• Ensure appropriate care provider documentation supports the patient’s anticipated discharge plan of care.
• Escalate deviations from the plan to the Physician Advisor as appropriate.
• Complete clear and concise documentation of the care plan.
• Identify and communicate any problems affecting patient flow, satisfaction, safety, length of stay, or outcomes.
• Function as a resource for governmental and healthcare industry regulations and ensure compliance.
• Inform the patient and family/caregiver of the plan of care and progression, facilitating communication and open dialogue.
• Facilitate Care Partner Huddles/Family meetings as needed.
• Attend and contribute to departmental staff meetings.
• Participate and contribute to multi-disciplinary committees and other workgroups as directed.
• Manage quality indicators such as avoidable delays, length of stay, resource utilization, patient satisfaction, patient flow, outlier management, and readmissions, suggesting improvement strategies.
• Assist with completion of PRIs upon request and as needed.
• Maintain and model the organization’s values.
• Demonstrate regular, reliable and predictable attendance.
• Perform other duties as required.

Requirements

• NY RN License
• 3-5 years experience in an acute care setting

Qualifications

• Bachelor’s degree in nursing or another healthcare-related field preferred
• 3-5 years in an acute care setting

Nice to Have

• Bachelor's degree in nursing or other healthcare-related field
• ACM certification
• CCM certification
• CMAC certification

Certifications