RN, Registered Nurse Care Manager - Health Plan Admin

Company: Christus Health
Location: Irving
Posted on: September 1, 2024

Job Description:

DescriptionSummary:The RN Care Manager (CM) II works with physicians and multidisciplinary team members to develop a plan of care for each assigned patient from admission through discharge. The CM ensures that the patient is progressing toward desired outcomes by continuously monitoring patient care through assessments and/or evaluations. Assesses and responds to patient/family needs by coordinating efforts of other team members. Identifies and resolves barriers that hinder effective patient care. The CM plans effectively to meet patient need, manage length of stay and promote efficient utilization of resources to include the facilitation of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursementResponsibilities:Coordinates/facilitates patient care progression throughout the continuumImplements and monitors the patients plan of care to ensure effectiveness and appropriateness of servicesIdentifies and escalates system barriers that are impeding diagnostic or treatment progressProactively identifies and resolves delays and obstacles to dischargeUses advances conflict resolution skills as necessary to ensure timely resolution of issuesCollaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate settingEnsures that all elements critical to the plan of care have been communicated to the patient/family and members of the healthcare team and are documented as necessary to assure continuity of careManages all aspects of discharge planning for assigned patientsProvide appropriate interventions which demonstrate knowledge of and sensitivity toward cultural diversity and the religious, developmental, health literacy, and educational backgrounds of the patient populationAssesses the patients formal and informal support system as well as available benefits and/or community resources.Meets directly with patient/family to assess needs and develop and individualized care plan in collaboration with the physicianEnsures and maintains plan consensus from patient/family, physician and payorProvide education, information, direction, and support related to patients goals of careActs as patient advocate to develop treatment plan and coordinate patient care and to transition patient to the appropriate next level of careDemonstrates and promotes respect for the dignity and rights of every patient while adhering to the safety standards and practices of the organization and the nursing professionCollaborates with the physician and other health care professionals to promote appropriate use of medical center resourcesProvides information and support to patients and families, helping them access needed resources within the medical center and communityActively participates in clinical performance improvement activities involving length of stay, resource utilization, avoidable days, cost per case, and readmissionsMeasures effectiveness of interventions through direct communication with post-acute care providers, patients, and caregiversPromotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency.Requirements:BSN Degree from an accredited nursing program or demonstrated success in CHRISTUS RN Care Manager I positionExcellent verbal and written communicationCritical and analytical thinking skillsDemonstrated clinical competencyWorking knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.Understanding of pre-acute and post-acute levels of care and community resourcesAbility to work independently and exercise sound judgment in interactions with physicians, payors, patients and their familiesThree or more years clinical experience in clinical practice or demonstrated success in CHRISTUS RN Care Manager I positionCase management and Utilization Review experience preferredRN License in state of employment or compact requiredCertification in Case Management or demonstrated success in CHRISTUS RN Care Manager I PositionWork Type:Full TimeEEO is the law - click below for more information:https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdfWe endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at (844) 257-6925.by Jobble

Keywords: Christus Health, Irving , RN, Registered Nurse Care Manager - Health Plan Admin, Executive , Irving, Texas