RN Case Manager: Expert Discharge & Care Coordination

UHC United Hospital Center; Stati Uniti; In loco; USD 60.000 - 90.000; Tempo pieno

Descrizione del lavoro

WVU Medicine is seeking a skilled nurse to lead transition/discharge planning for an assigned patient load. You will coordinate with the multidisciplinary team to ensure timely, patient-centered care and develop individualized plans with physician collaboration.

You will educate staff, patients, and families about the transition process, document progress, and assist with end-of-life decisions and financial coordination when needed.

Competenze

• Current Registered Nurse license issued by the state in which services will be provided or current multi-state RN license through the enhanced Nurse Licensure Compact (eNLC).
• Three (3) years clinical experience.

Mansioni

• Manages all aspects of transition/discharge planning for assigned patients in a timely manner.
• Collaborates with the multidisciplinary team to facilitate the transition/discharge process for designated caseload.
• Monitors patient progress and ensures the plan of care is patient-focused, high quality, efficient, and cost effective.
• Provides education to staff, physicians, patients and families for effective transition planning.
• Faces with patient/family to assess needs and develop individualized transition/discharge plans with physician input.
• Communicates with the team and post-acute providers about complex family dynamics impacting care.
• Initiates and facilitates referrals to post-acute services (homecare, DME, hospice, LTAC, rehab, SNF).
• Documents interactions and progress according to policy.
• Assists with completion of advanced directives and power of attorney forms.
• Coordinates financial/benefits assistance and entitlement referrals as needed.
• Uses electronic quality screens to identify delays and readmissions.
• Completes clinical reviews and applies utilization criteria for admissions and stays.

Conoscenze

RN license

Clinical experience

Formazione

BSN

Descrizione del lavoro

WVU Medicine is seeking a skilled nurse to lead transition/discharge planning for an assigned patient load. You will coordinate with the multidisciplinary team to ensure timely, patient-centered care and develop individualized plans with physician collaboration.

You will educate staff, patients, and families about the transition process, document progress, and assist with end-of-life decisions and financial coordination when needed.