Just like the children we serve, Children's is growing quickly and hiring a Nurse Case Manager to serve as a patient advocate, guiding patients through the health system in a timely and cost effective manner while maintaining a high standard of care. Work in partnership with physicians and other disciplines to coordinate care and facilitate a discharge plan of care. Promote efficient and effective service delivery through enhanced communication and coordination of the patient specific plan of care. Ensure the established standard of care and expected outcomes are achieved in a timely manner while facilitating appropriate resource utilization and enhancing customer satisfaction.
% of Time
Performs assessment/reassessment based on clinical indicators and anticipated services for appropriate level of hospital care considering safety, quality, and cost.
Meets with the family and health care team to assess for diagnosis, care needs, and discharge plans.
Introduces Nurse Case Management (NCM) role to family.
Completes NCM assessment and documents in progress note. The assessment is reevaluated according to changes in condition, and when transfers to another location occur.
Provides education to the family related to the assessment and plan of care.
Incorporates evidence-based practice in conducting the nursing assessment, care coordination, and the discharge process.
Develops plan of care with the family and health care team.
Acts as a resource to the health care team regarding patient-specific plan of care to include discharge needs or alternative levels of care.
Maintains up to date information regarding the patient-specific plan of care.
Develops action plan in collaboration with family, physician, healthcare team, and third-party payers.
Meets regularly with patient/family, developing a supportive relationship.
Ensures communication with interdisciplinary team.
Reassesses needs and provides appropriate interventions. Monitors and evaluates patient status.
Ensures patient-specific plan of care is met based on the input from the family, adjusts goals as needed.
Communicates plan of care and discharge plan with patient/family, health care team, home care liaison, and community providers.
Negotiates with third party payors regarding appropriate home care needs when necessary.
Utilizes evidence-based guidelines to anticipate length of stay (LOS) and assists in managing avoidable days.
Works with patient/family to assess needs related to diagnoses, care, and discharge plans, and to establish preliminary expectations of care delivery with family, ensuring that they are actively involved or represented in the plan of care.
Acts as a resource to the healthcare team regarding the patient-specific plan of care. Provides leadership to the care team to accomplish outcomes.
Participates in multidisciplinary care conferences for the patient/family in order to facilitate plan of care progress.
Analyzes variances from the plan and dispatches departmental and educational resources, communicating anticipated timeframes and working across departments to prevent or resolve delays in service.
Coordinates with the healthcare team to identify and implement appropriate discharge plans incorporating opportunities for alternative care when appropriate.
Coordinates scheduled transfer and transport to alternative levels of care when appropriate, to include authorizations for service and Preadmission Screening and Resident Review (PASSR).
Monitor/evaluate re-admit data and participate in multidisciplinary councils to address performance improvement and processes.
Communicates and collaborates with the Utilization Management (UM) Nurseas necessary to provide information relating to the plan of care, regulatory requirements, and benefits management. Understands the NCM and UM Nurse role in revenue cycle management.
Collaborates with the UM Nurse to identify and document Avoidable Days according to department processes.
Monitors system to report case management outcomes and works as a change agent in the resolution of systems issues.
Identifies opportunities for optimizing care delivery.
Participates in Shared Governance.
Regular attendance at work is an essential function of the job.
Perform physical requirements as described in the Physical Requirements section
Performs other duties as assigned.
KNOWLEDGE, SKILLS AND ABILITIES:
Demonstrates written and verbal communication skills
Ability to apply the nursing process to acute patient care to achieve outcomes
Current knowledge of the healthcare environment, including community resources and financial systems
Working knowledge of basic computer programs such as word, excel. Knowledge of smart phone use
Previous EPIC experience preferred
EDUCATION AND EXPERIENCE:
Bachelor's degree from an accredited college or university in nursing required
Minimum 5 years in nursing required, preferably in a pediatric setting
Current and valid Nebraska RN license/RN Compact license required
Certification in Basic Life Support required to work
Certification from a nationally recognized case management organization preferred