Located in central Denver’s historic Washington Park residential neighborhood, associates at Porter Adventist Hospital enjoy beautiful surroundings, leading technology, outstanding leadership and easy access to everything great central Denver has to offer. As a full-service Magnet® designated, 368-bed acute-care referral center specializing in cancer care, joint replacement, spinal care, advanced robotic surgery and organ transplantation, Porter Adventist Hospital treats some of the region’s most complex medical cases and surgery patients. Our Heart and Vascular Institute is the first and only program in Colorado to receive full Heart Failure Accreditation status from the Society of Cardiovascular Patient Care. We have also received numerous awards and honors including: The Healthgrades Patient Safety Excellence Award (2014); top 50th orthopedic program ranking by U.S. News & World Report with high performing honors in eight specialties (2014); an “A” rating from the Leapfrog Group for Patient Safety (2014), as well as many others. The Porter tradition of blending science and spirit began more than 75 years ago by Denver businessman Henry Porter with his generous donation after he experienced care at a Seventh Day Adventist Facility in CA and sought to bring that same philosophy of care to Denver. If you are ready for a career where the work you do truly transcends the walls of a hospital, we invite you to learn more at: http://www.porterhospital.org/
Job Description/Job Posting ID: 96427
Recruiter Contact: MandyGray@Centura.org
Clinic/Department: 8675 PAH CASE MANAGEMENT
Hospital: PORTER ADVENTIST HOSPITAL
Schedule: PRN Days
Shift: covering sick and vacation
The Case Manager is assigned to specific Hospital Units to facilitate the care plan for the inpatient episode, proactively monitor clinical quality and facilitate timely discharge. Using a collaborative interdisciplinary approach, the Case Manager will confirm the plan of care and focus on anticipation, integration and coordination of clinical care and discharge planning services necessary to meet the needs of patients in order to optimize clinical outcomes and resource utilization.
Graduate of Accredited School of Nursing
Prefer BSN or bridging to BSN
Current Colorado RN License
BLS certification from American Heart Association
WORK EXPERIENCE REQUIREMENTS
Minimum of 3 years clinical experience as Registered Nurse
Experience in case management, utilization review, nursing clinical quality or discharge planning preferred
Excellent communication/presentation skills.
Ability to multi-task, set priorities and maintain organization. Computer skills.
POSITION DUTIES (ESSENTIAL FUNCTIONS)
ASSESSMENT, DATA COLLECTION, ANALYSIS
Obtains reviews and analyzes information relative to admission in accordance with hospital policy and documents assessment using
ECIN and/or other clinical information system.
Assess/reassess patient’s clinical and psychosocial status, diagnosis, and treatment plan involving and communicating with
physician/physicians as needed.
Facilitates discharge planning using ECIN working with patients, families and treatment team making any needed referrals/arrangements and documenting actions. Participates in the Performance Improvement process through concurrent chart review and participation on clinical effectiveness teams. Documents Case Management actions and discharge planning upon initial assessment with updates promptly as patient’s needs change. The documentation must be complete in Meditech on the day of each patient contact. Proactively reviews medical records for compliance with Core Measure initiatives and other quality initiatives and confers with nursing staff on actions.
CONFIRMATION OF PATIENT GOALS AND PLANS OF CARE
Confirms treatment goals and anticipated plan of care through discussions with treatment team/review of documentation. Utilizes tools such as guidelines, criteria or clinical pathways to assist in facilitating plan of care and appropriateness. Communicates treatment goals or best practices to treatment team including physician using established criteria/guidelines. Daily communication with nursing staff regarding plans, barriers to discharges.
MONITORING PLAN OF CARE AND CARE COORDINATION
Assess, coordinates and evaluates use of resources and services relative to plan of care and discusses variances on an as needed basis with treatment team.
Communicates modifications in plan of care to treatment team and any needs for further documentation daily and/or as needed. Facilitates Family Conferences meetings on an as needed basis and documents outcome.
Participates and/or leads interdisciplinary rounds to facilitate plan of care and discharge.
Reviews variance in plan of care with Manager/Director as needed.
Assists to streamline the care delivery process to minimize or eliminate unnecessary steps or delays through application of Millman Guidelines. Facilitates and prioritizes prompt throughput of observation patients.
Identifies when variances occur in anticipated plan of care, tracks for process improvement, and refers to CMO or PA for peer review as needed.
Uses established criteria/guidelines for suitability of level of care, medical necessity, and continued stay and enlist Physician Advisor involvement as needed. Performs daily rounds with clinical team to address barriers to discharge and plans of care. Tracks avoidable days using ECIN. Monitors length of stay on ongoing basis for case load. Works with third party payers to satisfy utilization review requests and obtain approval of stays.
Participates in Case Management weekly meetings providing information on outliers for LOS and proactive solutions. Performs utilization review in accordance with UM Plan to include concurrent/retro reviews and verifying admission/bed status. Assists Case Management Manager/Director with clinical information for denial reversals. Daily review of all clinic bed, observation, 1 day inpatient stays and same day discharge charts for appropriate status orders, correct status in computer, calculation of obs hours for charging, obtaining appropriate orders for status change or no order on chart, within 24- 36 hours. Proactive management of factors influencing length of stay using critical thinking skills minimizing variance days. Participates in Utilization Review meetings. Obtains any regulatory documentation that is required.
Completes work with minimal supervision, striving for and achieving optimal outcomes.
Meets time commitments on assignments without reminders. Takes responsibility for own actions.
Recognizes own strengths and weaknesses and seeks/accepts constructive feedback, incorporating it into work.
Meets attendance and punctuality guidelines. Puts the patient, family and customer needs first.
Adapts to changes in the work environment and appropriately incorporates new information.
Effectively deals with pressure and uncertainty.
Deals effectively with a variety of people, personalities, and cultures.
* This job description is not intended to be an exhaustive list of all duties. Employee may perform other related duties as assigned.
X Medium Work - exert/lift up to 50 lbs force occasionally, and/or up to 20 lbs frequently, and/or up to 10 lbs constantly.
**The UR RN will review medicare cases/private insurance- inpatient and observation- extended recovery status- insurance tasks and denials- would like a RN with UR experience
Important notification to applicants as of Nov. 20, 2014: Effective Jan. 1, 2015, Centura Health will no longer hire tobacco users in Colorado and Kansas. The change to our policy does not apply to associates hired on or before Dec. 31, 2014. Centura Health is an Equal Opportunity Employer, M/F/D/V.