Care Management RN - Discharge Planning & Care Coordination

1106 Portercare Adventist Health System; United States; Presencial; USD 48.000 - 91.000; Jornada completa

Descripción de la vacante

AdventHealth in Denver, CO is seeking a Registered Nurse with care management/Utilization Management experience to support discharge planning across inpatient, observation and emergency settings.

You will participate in multidisciplinary rounds, assess patient and family needs, collaborate with payors for post-acute authorization, and develop comprehensive discharge plans to ensure timely transitions of care. CNA/CM experience preferred.

Formación

• Leadership skills
• Process and Outcome data analysis skills
• Critical thinking and problem-solving skills
• Ability to manage multiple tasks and prioritize levels of importance
• Customer service skills
• Ability to work with diverse populations
• Effective organizational skills
• Computer proficiency with Outlook e-mail and electronic medical records
• Flexibility in a complex healthcare environment
• Knowledge of community resources and post-acute care programs
• Knowledge of clinical and social factors affecting discharge planning

Responsabilidades

• Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge plans for all assigned patients to identify resources necessary at discharge and ensure a timely transition, escalating care delays to leadership as appropriate.
• Communicates with and educates patients and families regarding emotional, social, and financial impacts of illness and mobilizes family/community resources to meet identified needs while advocating for patient and family empowerment in making health care decisions and accessing needed services.
• Assesses readmitted patients for the patient’s and family’s perceived reasons for the readmission.
• Organizes and facilitates patient and family care conferences with the multidisciplinary team.
• Documents discharge planning evaluation, ongoing assessment, discharge plans, MDRs, barriers to progression of care, avoidable days, and patient and family needs according to standard work.
• Communicates with Payors patient’s needs for authorization for post-acute care as needed.
• Assesses patients’ and families’ wholistically for discharge planning needs in the inpatient, observation and/or emergency departments, including prior functioning, support systems, financial, and psychosocial in a timely fashion to avoid delays in discharge planning.
• Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors into the transition of care plan.
• Develops discharge plans with appropriate contingency plans throughout the hospital stay to ensure timely care coordination and progression of care, making arrangements for post-acute care services and facilities as well as community care for social needs.
• Leverages technology and follows standard work and best practices to communicate with post-acute care services and facilities to ensure patient care information is communicated for continuity of care, medical records are complete, and discharge reconciliation is accurate.

Descripción del empleo

AdventHealth in Denver, CO is seeking a Registered Nurse with care management/Utilization Management experience to support discharge planning across inpatient, observation and emergency settings.

You will participate in multidisciplinary rounds, assess patient and family needs, collaborate with payors for post-acute authorization, and develop comprehensive discharge plans to ensure timely transitions of care. CNA/CM experience preferred.