32 ED RN Case Manager - UR & Discharge Planning at Beth Israel Lahey Health Jobs in Plymouth, MA
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ED RN Case Manager - UR & Discharge Planning at Beth Israel Lahey Health
$93k-113k (estimate)
Full Time
3 Weeks Ago
Health eCareers is Hiring an ED RN Case Manager - UR & Discharge Planning at Beth Israel Lahey Health Near Plymouth, MA
- Job Type:** Per Diem
- Time Type:** Part time
- Work Shift:** Day (United States of America)
- FLSA Status:** Non-Exempt
Per Diem, scheduled according to department needs
Job Description**Position Summary:**
The Emergency Department Case Manager is responsible and accountable for patient trajectory by assisting the healthcare team in improved patient outcomes. The focus is to identify the most appropriate level of care while facilitating throughput. The ED Case Manager will assist in identifying patients appropriate for Admission, Observation, or other patient care status.
This role is structured around four major functions
Utilization Management
Care Coordination
Discharge Planning
Preventing Unnecessary Re-admissions
Each of these functions support the Care Transitions Department's goals of 1) Improving patient satisfaction and patient outcomes, 2) Decreasing length of stay, 3) Decreasing unit cost, 4) reducing readmissions.
Functions And Responsibilities**A. Utilization Management**
Performs review of anticipated admissions utilizing InterQual criteria to assess for appropriate level of care assignment.
Certifies Medicare admissions and utilizes Code 44 when appropriate
Serves as a resource to patients, physicians, administration and hospital employees regarding issues related to patient classification and reimbursement.
Refers inappropriate observation or anticipated admission cases to the Physician Advisor.
Provides real time interventions to prevent delays and ensure compliance and revenue integrity with health care regulations
Functions as a liaison between physicians and Physician Advisors Identifies and collects data regarding resource utilization for physicians, management and administration for evaluation and process improvement.
**B. Discharge Planning**
Creates and coordinates the overall transition plan of care based on initial assessment and concurrent collaboration with other care givers, external service organizations, agencies and healthcare facilities, community care and navigation services, and the patient and family/caregiver.
Facilitates smooth care transitions by ensuring appropriate clinical follow-up is arranged and referrals to proper post-acute providers are initiated.
Increases patient and family satisfaction with the discharge from the ED
Prevents unnecessary admissions for social reasons
Functions as a liaison between the DEM and community-based resources on an as-needed basis
Provides assessment, information, referrals, and other resource assistance to patient/family as needed
Facilitates treatment, admission, discharge, and/or transfer in collaboration with physician and primary nurse
Identifies high-risk social situations and works collaboratively with Social Work to coordinate resources to promote follow-up care
Communicates with the Care Transitions Department about incoming patients that have discharge planning needs
Assesses, coordinates and refers cases of suspected/actual abuse, domestic violence, or neglect to appropriate agencies
Obtains authorization for services for discharge as needed
Arranges for community services prior to discharge to meet patient's post-discharge needs with recognition and documentation of patient choice of service providers
Identifies potential quality & risk management issues based on acceptable standards of practice and refers cases to the Manager, Care Transitions or directly to the Risk/Quality Manager in her absence to ensure quality of patient care and prompt identification of potential problems.
Documents Care Transition notes briefly and concisely.
Advocates for the patient/family with other health care professionals and community agencies as indicated to enable them to negotiate various social systems.
Qualifications-Required-
State of MA Registered Nurse (RN)
3-5 years acute care nursing
Two years experience of recent utilization management and discharge planning
PreferredBachelor's degree in nursing or healthcare related field
Three years of recent utilization management and discharge planning experience
ED nursing and/or case management
Knowledge, Skills, And AbilitiesDemonstrates expertise in the utilization management and discharge planning principles, methods, and tools and incorporates them into the daily operations of the organization.
Possesses strong knowledge of DRGs, LOS, variance analysis, and discharge planning related to the utilization of health care resources.
Demonstrates clinical expertise to effectively facilitate the evaluation of the level of care required.
Develops and maintains strong collaborative, and supportive working relationships with peers, physicians, and other clinical professionals.
Provides and receives feedback in a positive and constructive manner.
Demonstrates excellent written, verbal, organizational and presentation skills.
Possesses knowledge of care delivery systems across the continuum of care, including trends and issues in care reimbursement.
Ability to multitask and work in a fast-paced environment
**As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more () about this requirement.**
**More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.**
**Equal Opportunity** **Employer/Veterans/Disabled**
Compensation Information$0.0 / - $0.0 /
Starting At: 0.0
Up To: 0.0
Job Summary
JOB TYPE
Full Time
SALARY
$93k-113k (estimate)
POST DATE
08/22/2024
EXPIRATION DATE
09/18/2024
WEBSITE
healthecareers.com
HEADQUARTERS
Denver, CO
SIZE
100 - 200
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