Registered Nurse (RN) Case Manager - PRN Days
Posted on: November 23, 2018
St. David's Georgetown Hospital is part of St. David's HealthCare, one of the largest health systems in Texas, which was recognized with a Malcolm Baldrige National Quality Award in 2014. St. David's Georgetown Hospital offers a range of services, including a 24-hour emergency department with a level IV trauma center; Certified Primary Stroke Center; Certified Chest Pain Center; inpatient and outpatient surgery; advanced pulmonary intervention; critical care capabilities; acute inpatient and outpatient rehabilitation; and maternity and newborn services with mother-baby couplet care close to home for Georgetown families. In conjunction with its parent campus, St. David's Medical Center, HealthGrades awarded St. David's Georgetown Hospital the 2016 America's 100 Best Hospitals Award, 2016 Patient Safety Excellence Award and the 2016 Outstanding Patient Experience Award-a unique trio of awards that only three hospitals in the nation were able to achieve-as well as the 2016 Distinguished Hospital Award for Clinical Excellence. Additionally, St. David's Georgetown Hospital was named to the list of 100 Top Hospitals by Truven Health Analytics for four years in conjunction with its parent campus, and the facility earned a national distinction for patient safety from The Leapfrog Group from 2012 to 2016.
The Case Manager works in conjunction with other members of the interdisciplinary care team using a proactive approach to facilitate effective and efficient patient care during the hospital stay. The Case Manager meets with each patient and/or family early in the course of care to activate anticipatory discharge planning for post hospital care. The Case Manager is responsible for comprehensive initial and ongoing chart review to ensure that appropriate services are rendered in the most appropriate setting. Additionally, the Case Manager is responsible for assigning admission and treatment criteria coding in accordance with Interqual Criteria & Texas Medical Foundation (TMF) guidelines.
ESSENTIAL JOB RESPONSIBILITIES
- Face-to-face visit with patients and/or family members for comprehensive assessment for discharge needs taking into account the patient's needs, current and prospective functional capacities, resources and support systems.
- Follow-up visits and phone calls with patients and/or families as needed.
- Accurate and timely utilization review of patient charts to insure appropriate utilization of hospital resources and facilities.
- Provision of clinical information to the Admission Nurse and to third party payers in support of the patient's admission and/or continued hospital stay.
- Active communication with the physicians regarding issues such as length of stay, admission and/or treatment criteria, how to render services in the most cost effective setting and any other patient care and/or resource and/or facility utilization issues that might arise.
- Comprehensive assessment, which takes into account the patient's, needs, current and prospective functional capacities, resources and support systems.
- Active listening and supportive counseling.
- Collaborative formulation of appropriate and realistic patient-centered. discharge plans including the arrangement of any necessary follow-up services such as durable medical equipment, home health and/or placement.
- Advocacy in support of the patient's right to self-determination.
- Acting as a liaison between patients, families, visitors, physicians, St. David's Georgetown staff and/or other community service.
- Thorough and timely documentation regarding the patient's problems, goals, plans. and/or relevant Case Management interventions.
- Participation in and/or facilitation of Interdisciplinary Care Conferences.
- Timely attendance at and positive, active participation in departmental meetings.
- Education and/or consultation services to patients, families, visitors, physicians, St. David's Georgetown staff and the community regarding issues such as:
- Admission class/status and criteria, especially the appropriate use of observation status;
- Treatment criteria;
- Alternative care delivery options and settings;
- Community resources;
- Assistance in providing and/or compiling data and reports for the Utilization Management Committee, the Department Director and/or Administration.
Primary Populations Served:
- Patients - Mostly adults (18 years and older) including geriatric patients (65 years and older) with occasional neonates (0-28 days), infants (28 days-2 years), pediatrics (2-12 years), and adolescents (12-17 years).
- Families - All ages.
Secondary Populations Served:
- St. David's Georgetown staff
- Employee's conduct must reflect the company's values and a commitment to the Code of Conduct, ethics and compliance program.
- Adheres and upholds all service behaviors as listed in the I CARE value commitment and other departmental initiatives.
Keywords: HCA., Georgetown , Registered Nurse (RN) Case Manager - PRN Days, Executive , Georgetown, Texas
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