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: 88923
Recruiter Contact: MandyGray@Centura.org
Clinic/Department: 8675 PAH CASE MANAGEMENT
Hospital: PORTER ADVENTIST HOSPITAL
Schedule: PRN- 4 shifts per month- weekend rotation, holiday
Facilitates the care plan for the inpatient episode, proactively monitor clinical quality and facilitate timely discharge. Using a collaborative interdisciplinary approach, confirms 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.
• CO Registered Nurse
WORK EXPERIENCE REQUIREMENTS
• 4 years of clinical experience as a Registered Nurse or Case Mgmt or Utilization review or discharge planning or quality in hospital setting.
• Experience in case management, utilization review, nursing clinical quality or discharge planning preferred
• CO Registered Nurse
POSITION DUTIES (ESSENTIAL FUNCTIONS, INCLUDE % OF TIME)
ASSESSMENT - 30%
• Reviews & analyzes information relative to admission in accordance with hospital policy and documents assessment using ECIN and/or other clinical information system.
• Assesses patient’s physical, psychosocial, cultural and spiritual needs through observation, interview, review of records and interfacing with patient, physician and interdisciplinary team and caregivers to assist patient/family in making decisions toward next level of care.
• 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 CM actions taken in medical record.
• Proactively reviews medical records for compliance with Core Measure initiatives and other quality initiatives and confers with nursing staff on actions needed.
PLAN OF CARE/DISCHARGE INSTRUCTIONS - 45%
• 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.
• 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.
• Facilitates family conference 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, CM, Director/Manager as needed.
• Assists to streamline the care delivery process to minimize or eliminate unnecessary steps or delays and promote timely Peer Review.
• Interfaces closely with Social Worker, Homecare Coordinator and Utilization Reviewer to ensure seamless and timely delivery of services and avoid unnecessary delays in discharge.
• Maintains updated referral resource lists.
UTILIZATION REVIEW - 25%
• 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 and continued stay and enlist Physician Advisor involvement as needed.
• Tracks avoidable days using ECIN.
• Monitors length of stay on on-going basis for case load.
• Works with third party payers to satisfy utilization review requests and obtain approval of stays.
• Participates in case management weekly meeting providing information on outliers for LOS and proactive solutions.
• Performs utilization review in accordance with UM Plan to include concurrent/retro reviews and verify admission/bed status.
• Assists CM Manager/Director with clinical information for denial reversals.
• Daily review of all clinic beds, 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.
* This job description is not intended to be an exhaustive list of all duties. Employee may perform other related duties as assigned.
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.