Case Manager,Registered Nurse - Care Management (CH)

Catholic Health System Lebanon, IN
* Case Manager, Registered Nurse – Care Management (Catholic Heath)

As a member of the multidisciplinary healthcare team, The Case Manager - Registered Nurse effects a process of assessment, planning, facilitation and advocacy for options and services to meet an individual's health needs through communication and available resources to promote quality cost-effective care.

The Case Manager - Registered Nurse, through direct communication with the patient, family the physician, and the appropriate service personnel, assesses, monitors, and facilitates healthcare services and needs throughout the patient experience, from the ED of the acute care hospital stay to entry in post-acute care, in order to optimize the outcome for all concerned. This includes validation of appropriate level of care (severity of illness), efficient and effective care delivery (intensity of services) in the context of medical necessity guidelines and/or clinical pathways and/or risk stratification tools with safe discharge to the next appropriate level of care.

The Case Manager - Registered Nurse completes appropriate level of care assessments, continued stay reviews, and screening/referral for post-acute levels of care utilizing established criteria and meeting local, state, and federal regulatory requirements.

The Case Manager - Registered Nurse establishes a professional, resource based relationship with all concerned, demonstrating the mission, values, and vision of Catholic Health.

REPORTS TO: Site Manager for Care Management

SUPERVISORY RESPONSIBILITIES:

None

SKILL AND EDUCATIONAL REQUIREMENTS (MINIMUM):

Educational Requirements

* BSN degree or RN with BSW, BS Education, or BS in Health related field

* Registered Nurse, licensed ( unrestricted ) in New York State

* New York State PRI & Screen certification hospital and community recommended

* National Certification in Case Management preferred

Experience Requirements

* Two years medical surgical nursing and/or job related experience

* Knowledge of admission practices and procedures, as well as related laws, regulations and guidelines pertaining to hospital, homecare, long-term care, sub-acute and acute rehab operations.

* Prior insurance /managed care/utilization review experience in the role of a Case Manager or Disease Manager, Population Health , Discharge Planning or Chronic Care Manager

Knowledge, Skills and Ability

* Possess the ability to make independent decisions when circumstances warrant such action, deal tactfully with personnel, residents/patients, family members, visitors, etc., and seek out new methods and principles and be willing to incorporate them into existing practices.

* Possess ability to educate, inform, advocate, promote and facilitate health care options, and demonstrate the willingness to work harmoniously with a team approach. Must have patience, tact, cheerful disposition and enthusiasm and be able to relate to and work with ill, disabled, elderly, emotionally upset residents/patients and their families.

* Must be able to read, write and speak the English language.

* Must be able to use a computer for data entry and to send and retrieve webmail.

WORKING CONDITIONS:

* Maintains a professional appearance and appropriate professional demeanor at all times.

* Involved with residents/patients, families, visitors, government agencies/personnel, associates under all conditions and circumstances. Communicates with the medical staff, hospital and agency personnel, and other departments.

* Willingness to work beyond normal working hours, and in other positions temporarily, and/or at other locations when necessary.

* Variable schedule which may include weekends and holidays. May be requested to travel to multiple hospital and community sites.

* Subject to hostile and emotionally upset patients, family members, frequent interruptions.

Environment

* Normal heat, light space, and safe working environment; typical of most office jobs.

* Occasional exposure to one or more mildly unpleasant physical conditions.

* Intermittent exposure to a few unpleasant physical conditions.

* Frequent exposure to many disagreeable physical conditions.

* Continuous exposure to extremely disagreeable physical conditions.

* Normal heat, light space, and safe working environment; typical of most office jobs.

* Occasional exposure to one or more mildly unpleasant physical conditions.

* Minimum physical effort required, typical of most office work

* Significant amount of walking within the acute care facility

Physical Effort

ACTIVITY & STRENGTH: (MEDIUM)

Low Lift (floor to knuckle): Occasional 0 to 2.6 hours/day (21-50 lbs.); Frequent 2.7 to 5.3 hours/day (11-20 lbs.); Constant 5.4 to 8 hours/day (1-10 lbs.)

Mid Lift (knuckle to shoulder): Occasional 0 to 2.6 hours/day (21-50 lbs.); Frequent 2.7 to 5.3 hours/day (11-20 lbs.); Constant 5.4 to 8 hours/day (1-10 lbs.)

High Lift (shoulder and above): Occasional 0 to 2.6 hours/day (21-50 lbs.); Frequent 2.7 to 5.3 hours/day (11-20 lbs.); Constant 5.4 to 8 hours/day (1-10 lbs.)

Full Lift (floor to shoulder): Occasional 0 to 2.6 hours/day (21-50 lbs.); Frequent 2.7 to 5.3 hours/day (11-20 lbs.); Constant 5.4 to 8 hours/day (1-10 lbs.)

Carry: Occasional 0 to 2.6 hours/day (21-50 lbs.); Frequent 2.7 to 5.3 hours/day (11-20 lbs.); Constant 5.4 to 8 hours/day (1-10 lbs.)

Push: Occasional 0 to 2.6 hours/day (21-50 lbs.); Frequent 2.7 to 5.3 hours/day (11-20 lbs.); Constant 5.4 to 8 hours/day (1-10 lbs.)

Pull: Occasional 0 to 2.6 hours/day (21-50 lbs.); Frequent 2.7 to 5.3 hours/day (11-20 lbs.); Constant 5.4 to 8 hours/day (1-10 lbs.)

Overall Strength Category: Occasional 0 to 2.6 hours/day (21-50 lbs.); Frequent 2.7 to 5.3 hours/day (11-20 lbs.); Constant 5.4 to 8 hours/day (1-10 lbs.)

Dictionary Of Occupational Titles

Constant (C) 67-100% Workday

Occasional - Frequent (F) 34-66% Workday

Occasional (O) 0-33% Workday

Not Present (N)

Activity - Job Demand

Walk – Frequent

Climb Stairs – Occasional

Stoop – Frequent

Kneel – Occasional

Crouch – Occasional

Reach (immediate) – Frequent

Reach (overhead) – Occasional

Handling – Frequent

Fingering - Frequent

Sitting – Occasional

Standing – Constant

Push Cart - Frequent

Pull Cart - Frequent

HR Use Only: NYS DOL HR Use Only: WW HR Use Only: HH