Case Management Supv Observation Patient Coordinator

Rhode Island Hospital; United States; On-site; USD 90,000 - 110,000; Full time

Job summary

Rhode Island Hospital is seeking an experienced RN in Case Management to coordinate discharge planning for observation patients. You will collaborate with medical staff, utilization management, and the care team to ensure timely, efficient discharge processes.

The role requires Rhode Island licensure, a bachelor’s degree, and BLS certification, with a preferred Case Management certification within 1 year. Three years of relevant clinical experience is expected.

Qualifications

• Registered nurse licensed in Rhode Island.
• Bachelor's degree required.
• Certification in Case Management by a national organization preferred or to be obtained within 1 year of hire.
• BLS Certification required.
• Three years of clinical experience with case management or discharge planning preferred.

Responsibilities

• Partners with medical staff to facilitate discharge plans for observation patients.
• Identify high-risk patients and assist in timely discharge planning.
• Collaborate with utilization management and participate in daily observation rounds.
• Provide clinical supervision to Case Management staff as needed.
• Participate in system-wide 24/7 coverage for clinical/scheduling issues.
• Inform team of insurance qualifiers affecting the discharge plan.
• Coordinate discharge with patients, families, and post-acute services.
• Lead process improvements to reduce delays and readmissions.
• Participate in department and system-wide improvement activities.
• Assist in orientation of new staff.

Skills

RN licensure

Case management

Discharge planning

Analytical skills

Supervisory skills

Education

Bachelor's degree

Certification in Case Management (preferred)

Job description

SUMMARY: Reports to the Director of Case Management or designee. Provides coordinated care support to facilitate and expedite discharges of observation patients. Participates in daily observation rounds and collaborates with the clinical healthcare team across the patient care continuum. As a member of that team, shares responsibility for the implementation of the discharge plan; ensures efficient and effective delivery of patient care services through the appropriate utilization of healthcare resources

Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect and Excellence, as these values guide our everyday actions with patients, customers and one another.

Core Success Factors

• Instill Trust and Value Differences
• Patient and Community Focus and Collaborate

Leadership Aptitude

• Ensure Accountability and Build Effective Teams
• Drive Vision and Purpose and Optimize Work Processes

By applying core and leadership competencies, leaders help Brown University Health achieve its strategic goals.

RESPONSIBILITIES

• Partners with medical staff, case manager, utilization manager, and other members of the healthcare team in collaboration with the patient/family to facilitate the plan of care for patients who are admitted observation. Proactively identifies high-risk patients within this patient population and assists case management to facilitate timely discharge plans.
• Collaborates with utilization management to ensure communication between case management and utilization management teams.
• Participates in daily observation rounds to collaborate with members of the patient's healthcare team as well as to evaluate and facilitate development and implementation of the discharge planning process.
• Provides clinical supervision and work direction to Case Management staff as needed.
• Participates in system-wide 24/7 coverage for clinical and/or scheduling issues.
• Ensures team is informed of insurance qualifiers that may affect the discharge plan. Discuss approaching discharge readiness of patients.
• Identify and assess readmitted patients and complex patients in collaboration with members of the healthcare team to coordinate discharge.
• Advocates for the patient and advises the patient regarding financial implications of their discharge plan when coordinating care for the patient. Communicates the discharge plan, including post facility agency acceptance, to patients, families and all members of the care team.
• Provides care plan direction for the advancement of a patient care delivery system which supports managed care strategies and decreases readmission risk.
• Demonstrates knowledge of federal and state rules and regulations.
• Reviews and acts as a change agent by identifying opportunities to improve patient flow and identifies and reduces service delays through problem resolution and follow-up.
• Identifies and tracks service and discharge patient delays.
• Participates in department, affiliate and system level improvement activities as requested: i.e. weekly long LOS reviews, interdisciplinary rounds, readmission reviews, LOS initiatives.
• Participates in orientation of new staff as requested.
• Participates in ongoing education-related professional activities and affiliations to maintain an advanced level of knowledge of patient care services third party payer and managed care requirements and case management.

MINIMUM QUALIFICATIONS

• Licensure as Registered Nurse in the State of Rhode Island by the Rhode Island Board of Nursing or licensure as a Registered Nurse in accordance with the Nurse Licensure Compact agreement of the National Council of State Boards of Nursing.

BASIC KNOWLEDGE

• Graduate of a School of Nursing with current license to practice as a Registered Nurse in the State of Rhode Island.
• Bachelor's Degree required.
• Certification in Case Management by a nationally organization preferred or to be obtained within 1 year of hire.
• BLS Certification required.

EXPERIENCE

• Analytical skills necessary to evaluate patients, programs, and procedures. Administrative and supervisory skills necessary to address case management staff functions in the department and/or assigned clinical area.
• Demonstrated ability to exercise independent judgment.
• Refers specific complex problems to Manager or Director of Case Management or designee, where clarification of departmental policies and procedures may be required.
• Interpersonal skills necessary to establish and maintain effective working relationships and to supervise and coordinate care management activities in the clinical area.
• Three years of clinical experience with recent experience in case management, community case management, patient navigation, or discharge planning is strongly preferr