Clinical Nurse Case Manager

ID: 1739
Department: Case Management
Location: Bartlett Regional Hospital
Employment Status: Casual
Daily Hours Worked: 8
Describe Work Schedule: innovative
Pay Range: $27.93 - $34.17 DOE

Description

 

Position Title

Clinical Nurse Case Manager (205)

Department(s)

Case Management (01.8410)

Reports to

Director, Case Management (160)

Population Served

Patients, families, visitors and volunteers, co-workers and physicians and outside vendors and other agencies.

CARE Values

C ourtesy – We act in a positive, professional and considerate manner, recognizing the impact of our actions on the care of our patients and the creation of a supportive work environment.

A ccountability – We take responsibility for our actions and their collective outcomes; working as an effective, committed and cooperative team.

R espect – We treat everyone with fairness and dignity by honoring diversity and promoting an atmosphere of trust and cooperation. We listen to others, valuing their skills, ideas and opinions.

E xcellence – We choose to do our best and work with a commitment to continuous improvement. We provide high quality, professional healthcare to meet the changing needs of our community and region.

 

POSITION SUMMARY:

Participates as a member of a case management team which includes nurse and social work  case managers, physicians and the multidisciplinary team to ensure that optimal care is delivered in the most efficient and cost-effective manner in the hospital setting by monitoring use of resources to ensure effective outcomes.

 

ESSENTIAL FUNCTIONS:

  • Utilizes Intensity of Service/Severity of Illness criteria when evaluating necessity of admission, continued stay and appropriateness of discharge.
  • Screens for the utilization of appropriate ancillary services/facility resources;
  • Obtains orders for appropriate diagnostic studies/procedures while the patient is an inpatient.
  • Develops an individualized discharge plan for patients from newborns to geriatrics in collaboration with case management team which includes the physician.
  • Performs clinical reviews with representative of third party payers as required by payers.
  • Works with case managers assigned to patient by health care plan to ensure positive post hospital outcomes.
  • Participates in daily unit based case management multidisciplinary rounds to identify patient’s clinical appropriateness for LOS and to facilitate discharge planning process.
  • Participates in planning and implementing programs related to
    the department, including development and implementation of clinical
    paths and denials/appeals management, preparation of statistical
    reports, policies/procedures, etc.
  • Screens charts during review process for Quality Improvement
    indicators, monitors & reports risk management and infection control issues.
  • Able to utilize verbal and written skills in communication with internal and external customers.


NON-ESSENTIAL DUTIES

  • Participates on hospital/department ad hoc committees/teams and projects.
  • Participates in professional and/or community organizations.
  • Performs other related duties, as assigned.

 

AGE-RELATED COMPETENCIES

Recognizes the unique characteristics of each stage and age of human development and utilizes this information when making decisions related to continued care and discharge needs.

 

KNOWLEDGE, SKILLS AND ABILITIES

  • Basic computer literacy and ability to effectively learn new software programs required and ability to efficiently operate a variety of automated office equipment such as print/copy/scan/fax machine, calculators, etc.
  • Ability to use accurate, clear and concise oral and written communication
  • Ability to work as a team and maintain effective working relationships
  • Ability to critically think, analyze, and communicate findings effectively
  • Ability to work independently and perform assignments with minimal direction
  • Ability to ask questions when issues are not well-understood

 

MINIMUM REQUIREMENTS (the following are minimal qualification necessary for entry into this classification)

EDUCATION:  Graduation from an accredited School of nursing.  BSN preferred.      

 

EXPERIENCE:  Minimum 3 years current acute care nursing experience. Preferred, 1 year experience in utilization review, case management, care coordination ,quality management or similar role. Ability to effectively interface with a wide variety of people and to provide excellent customer service.  Strong organizational skills with attention to detail required.   Basic personal computer skills required; prior experience with Meditech preferred.

 

LICENSE(S):  Current State of Alaska RN license. 

 

CERTIFICATION(S):  Minimum attendance at 16 hours of related continuing education programs per year.  Certification in Utilization and/or Case Management preferred or willing to obtain within two years of employment in position.

 

PHYSICAL DEMANDS:

Light to moderate physical activity involving office procedures. Prolonged sitting with some walking throughout the facility.   Manual dexterity for extensive keyboarding and telephone use.  Infrequent light to moderate lifting.  Emotional stress related to dealing with varied psychosocial needs of patients/families and occasional heavy workload.

 

For specific physical demands of position, including vision, hearing, repetitive motion environment, see attached Description of Physical Demands. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the positions.

 

Hazardous Exposure/Working Conditions:    

Exposed to hazards associated with electrical equipment. Minimal risk of exposure to hazardous materials, blood and body fluids, communicable diseases, violent behaviors, chemical elements.  Work is carried out in office setting.  

 

 

DISCLAIMER

The above statements reflect the general details considered necessary to describe the principle functions of the job as identified, and shall not be considered as a detailed description of all work requirements that may be inherent in the position. BRH operates 24 hours per day, 365 days per year. The operational needs of departments and safety of patients may require that employees be available to work all shifts, weekends and holidays and in any department to meet the needs of the patients.





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