Care Manager: Discharge Planner & Patient Advocate (RN)

Kettering Health; United States; Presencial; USD 72 000 - 96 000; Tempo integral

Resumo da oferta

Kettering Health Main Campus is seeking a Care Manager (RN) to assess patients and families, develop plans, and align supportive services for transitions from hospital to next care level. You will collaborate with physicians, nursing, and ancillary teams to optimize social functioning and patient-centered outcomes.

The role requires proactive discharge planning, care coordination across settings, and motivational interviewing to promote healthier lifestyle choices for high- and moderate-risk

Qualificações

• RN licensed to practice in Ohio
• Charge Nurse / Case Manager / Care Coordinator experience preferred
• BSN required, Master's degree preferred

Responsabilidades

• Pro-active discharge planning
• Review readmission risk assessment tools and barriers
• Facilitation of interdisciplinary huddles and collaboration
• 1:1 patient and family interviews on moderate and high risk patients
• Evaluation of readmission factors contributing toward inappropriate utilization
• Collaboration with physicians, nursing, and ancillary services in development of safe, next-phase planning
• Communication on Care Planning in written and/or verbal format to next level of care
• Facilitate partnership with members across the continuum for aligned outcomes
• Identification of care gaps in disease states
• Create customized plan for moderate and high risk patients as they transition from hospital to next level of care
• Patient and family interaction on regular intervals with patient-centric goals
• Utilization of motivational interviewing techniques to assist patients toward healthier lifestyle choices
• Facilitate partnership with members across the continuum for aligned outcomes

Conhecimentos

Interdisciplinary collaboration

Discharge planning

Motivational interviewing

Patient communication

Formação académica

BSN

MS in Nursing or related field

Ferramentas

EPIC

Descrição da oferta de emprego

Kettering Health Main Campus is seeking a Care Manager (RN) to assess patients and families, develop plans, and align supportive services for transitions from hospital to next care level. You will collaborate with physicians, nursing, and ancillary teams to optimize social functioning and patient-centered outcomes.

The role requires proactive discharge planning, care coordination across settings, and motivational interviewing to promote healthier lifestyle choices for high- and moderate-risk