Facilitates patient care from pre-admission to discharge by managing, coordinating, and monitoring resources to achieve optimal financial outcomes, resource utilization and quality service.
- Provides education to the patient/family regarding the disease processes and planned treatment/intervention as it relates to discharge plans.
- Reviews hospital records to determine medical necessity for admission and continued stay according to specific criteria and regulations.
- Utilizes effective communication strategy with patients, family, physicians, nurses, staff members and other professionals to achieve desirable or acceptable patient outcomes and a perception of satisfaction from the individuals involved.
- Plans, organizes and prioritizes work to obtain the greatest impact on clinical, financial and service outcomes.
- Facilitates post-hospitalization discharge needs of the high risk patient. Coordinates services in conjunction with social worker.
- Demonstrates ability to accomplish quality of care and length of stay goals.
- Maintains communications with all relevant services to ensure quality care and timely discharge planning.
- Flags and refers quality issues, suggests solutions and facilitates implementation of selected solutions.
- Actively seeks innovative methods for improving service in the area of case management. Participates in RAC audit steering committees and post-acute tracking.
- Provides guidance and direction in discharge planning to social workers.
- Collects and documents accurate data within established time frame.
- Billing certifications needed for one day stay admissions, level of care changes and denied day are faxed to the billing department within 3 days of patient’s discharge.
- Assesses and identifies patients requiring Case Management intervention in the Emergency Department.
- Collaborates with other team members to assure appropriate bed assignment and admission through application of Interqual criteria.
- Develops an initial discharge plan for selected patients in both Emergency Department admitted patients and observation patients.
- Offers alternative care settings when criteria indicates a need or additional clinical documentation is required.
- Participates in performance improvement activities in Emergency Department in an effort to provide optimal outcomes and patient and staff satisfaction.
- Serves as a resource to the Emergency Department and hospital as it relates to System/community resources and nursing care facilities for OBS, ED, and admitted patients.
- Works with Emergency Department and attending physician to facilitate use of admission order sets.
- BSN or Bachelor’s Degree in related field or current enrollment in BSN or related Bachelor’s Degree program required.
- Two years general clinical hospital experience.
Licenses and Certifications:
- RN license required/NJ.
Required Knowledge and Skills:
Knowledge of utilization, quality improvement or case management required. Computer literacy preferred. Strong professional, organizational, and interpersonal skills to effectively relate with all members of the healthcare team.
Normal office environment with frequent exposure to patient care areas.
Potential for exposure to blood and/or body fluids.
Sitting – Occasionally
Standing/Walking – Frequently
Kneeling/Stooping – Never
Bending/Climbing – Never
Reaching above shoulder, at waist or below waist – Never
Lifting/Pushing or Pulling up to 40 pounds – Never
Lifting/Pushing or Pulling over 40 pounds – Never
Typing/Filing – Frequently
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
CentraState Healthcare System prohibits discrimination based on arbitrary consideration of such characteristics such as race, color, religion, national origin, ancestry, gender (including pregnancy), affectual or sexual orientation, gender identity or expression, marital status, age, physical or mental disability or limitation, medical condition, genetic information, or veteran or military status, as well as any other legally protected class of persons and acts, in accordance with applicable State and Federal laws.