- Coordinates the care and services for patients identified as needing assistance or meeting Care Management criteria. Collects in-depth information about a patient’s condition, situation and functioning to identify individual needs in order to develop a plan to meet those needs. Determines specific goals and actions based on assessment. Coordinates discharge planning. Executes specific interventions to meet established goals. Organizes, integrates and coordinates the necessary resources to accomplish the goals and plan.
- Assesses the patient’s prior level of functioning, access to and/or use of community resources and available support systems. Assists the care team in developing a plan of care which includes, but is not limited to: assuring appropriateness of services and care setting, assuring individualized support and education, determining the need for continued services, planning for discharge, and identifying and connecting patients/families with available community resources if needed. Collaborates with Physicians and other members of the health care team on the patient’s behalf.
- Completes timely Utilization Review per contract, both concurrently and retrospectively, being responsive to payer needs. Identifies appropriate admission and continued stay issues. Enhances the quality of patient care through effective and efficient use of resources. Helps to identify strategies for reducing length of stay and appropriate utilization of services. Utilizes criteria including clinical pathway data and implements strategies to resolve controllable variances.
- Attends, facilitates and participates in rounds and case conferences. Monitors efficiency and availability of services and evaluates outcomes through variance tracking, data collection.
- Provides education to ancillary departments/floors regarding case management, discharge planning and their role in the planning process. Participates in multidisciplinary groups and development of guidelines. Identifies opportunities for physician education regarding length of stay, resource utilization and clinical documentation related to justification for hospital services. Facilitates coaching and education to physicians.
- Promotes mission, vision, and values of SCL Health, and abides by service behavior standards.
- Performs other duties as assigned.
- May be required to float to other departments (within scope of competency and qualifications) based on business need.
- May be required to be placed on-call during a regularly scheduled shift
- Graduation from an accredited nursing school is required.
- Current valid State RN License is required.
- Three (3) years of experience as a Registered Nurse is required.
- Bachelor's degree in nursing is preferred.
- Certified Case Manager (CCM)
Organization: Saint Joseph Hospital, Denver, CO
Primary Location: CO-Denver/Boulder/Surrounding Areas-Denver
Department: SJD-Social Work Services
Shift: Day Shift
Job Number: 18003055