Position Type: Regular
Scheduled Hours per 2 week Pay Period: 80
Primary Location: AR > LITTLE ROCK > ST VINCENT INFIRMARY
JOB SUMMARY: The role of this job is to coordinate care across a continuum or episode of care; facilitating the achievement of quality outcomes, negotiating, procuring, and coordinating services and resources needed by patient/families; intervening at key points ( and/or at significant variances from the usual pattern of care: for individual patients; identify issues that consistently have a negative quality/cost impact; and creating opportunities and systems to enhance outcomes.
Education: RN licensed in the state of Arkansas.
Experience: One (1) year experience in case management or utilization review or clinical pathway development. Five (5) years experience in a clinical setting: Two (2) years charge nurse/team leader or related experience. Posses critical thinking and communication skills.
Skills: Telephone with voice mail, FAX machine, pagers, and computer.
Provides clinical information to third party payors in the following ways:
b) retrospective review
c) faxing information to other agencies when requested
Demonstrates discretion when dealing with sensitive issues involving patients, families, and physicians to maintain confidentiality of patient and hospital records.
Contacts physicians as needed regarding utilization issues and/or discharge planning.
Retrieves voice mail and/or answers pages within 30 minutes while on duty.
Informs other ancillary personnel of discharge plan.
Implements appropriate referrals to Physician Advisor in a timely manner.
Maintains positive open communication with physicians, interdisciplinary care team members, and department director.
Documents and analyzes data. Reports instances of inappropriate patient care, discharge delays, etc. etc.
Documents accurately and completes information related to third party authorization of hospital services.
Identifies avoidable days/saved days and enters into the appropriate automated program as indicated.
Documents discharge plan on medical record as needed
3. COMPLIANT CLINICAL DOCUMENTATION
Facilitates appropriate clinical documentation to ensure the level of services and acuity of care accurately reflected in the medical record.
Updates DRG worksheet to reflect any changes in patient status, procedures/treatments, and confers with the physician to finalize diagnosis.
Conducts follow-up reviews of clinical documentation to ensure issues discussed and clarified with the physician have been recorded in the patient's chart.
Assists in the medical screening process by documenting appropriateness of patient admission, working DRG & LOS
information on the worksheet, and computer system as appropriate.
CASE MANAGEMENT -2-
Cases are reviewed using the appropriate criteria for the following:
a. level of care
b. medical necessity
c. readiness for discharge
Reviews record of all patients on observation status and intervenes as needed.
Reviews records of all patients on assigned units and intervenes when indicated.
Utilizes hospital policy in handling request for medical record information for patients.
Demonstrates clinical knowledge skills/abilities for the patient population served.
Third party reviews are completed on assigned areas within one working day from the day of request.
Follow-up on any hospital system, departmental issues, and physician issues promptly.
Case load requirements are prioritized to meet multiple objectives including, but not limited to the following:
a. Interventions to manage quality / cost of care
b. Multidisciplinary patient conferences
c. Communication with care team members
d. Department meetings
e. Assistance to other Case managers
f. Documentation of days certified, days denied, and authorization numbers
g. Documentation of patient type
6. PERFORMANCE IMPROVEMENT/PROFESSIONAL DEVELOPMENT
Participates in department training programs/inservices.
Educates internal staff on clinical documentation guidelines.
Participates in case reviews.
Attends staff meetings except when excused by supervisor.
Participates in the orientation of new employees.
Demonstrates awareness of fiscal responsibility and impact of actions of the department and hospital budget.
Knowledge of all hospital wide emergency procedures.
Participates in QI/PI data collection, evaluation, and recommendations for improvement.
Completes yearly competencies to include: fire/safety , OSHA, abuse/neglect, and patient safety goals.
7. CUSTOMER SERVICE / SATISFACTION
Demonstrates service excellence behaviors routinely in encounters with all customers, i.e. coworkers, patients, visitors, physicians, etc.
Nonverbal communication conveys a sincere, courteous, and helpful attitude.
Anticipates and responds to the needs of all customers.
Demonstrates flexibility and cooperation in working with others.
Maintains a positive attitude.
Maintains confidentiality per St. Vincent Health System policy.
7. MAY PERFORM OTHER DUTIES AS ASSIGNED
Your time at work should be fulfilling. Rewarding. Inspiring. That's what you'll find when you join one of our non-profit CHI facilities across the nation. You'll find challenging, rewarding work every day alongside people who have as much compassion as you. Join us and together we'll create healthier, stronger communities. Imagine your career at Catholic Health Initiatives!
As a Registered Nurse, you will be responsible for delivering the highest quality patient care according to the specific orders of each patient's individual physician. This will involve, utilizing your knowledge and skills to educate patients and their families on prevention and healthy habits.
Additional responsibilities for this health care role include:
- Monitoring patients' conditions and assessing their needs
- Collaborating with physicians and nurses to devise individualized care plans for patients
- Administering patients' medications and providing treatments according to physicians' orders
- Fostering a supportive and compassionate environment to care for patients and their families
We are looking for a responsible and compassionate Registered Nurse with top-notch clinical skills, a caring attitude, and the ability to work independently with minimal supervision. It is also important to display excellent verbal and written communication and interpersonal skills as well as the ability to effectively educate patients and their families on the in-home healthcare process.
Additional requirements for this role include:
- Current Registered Nurse (RN) license that allows you to practice in our state
- Graduate of an accredited nursing program
- Experience as a Registered Nurse preferred
- Basic Life Support (BLS) required
- Specialty certification (ex: CCRN, CNOR, CEN) preferred
- Additional certification or licensure may be required for some specialty areas
Join us at Catholic Health Initiatives, and become a part of our faith-based health system. Additional Information
- Requisition ID: 2019-R0234155
- Schedule: Full-time
- Shift: Day Job
- Market: CHI St. Vincent
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