ESSENTIAL FUNCTIONS:
Participates in the management of situations in a manner that manages risk and reflects systems-thinking. Challenges the "norm" using sound analytical skills and effectively resolving issues. Demonstrates creative problem-solving skills, utilizing innovation and a team approach. Demonstrates responsibility in procedural and documentation requirements. Demonstrates commitment to continual professional and personal growth. Demonstrates accountability for communication, availability as required, and progress toward goals. Participates in policy development, meetings training, and other key departmental or JSMC focuses according to scope of practice. Performs data collection and analysis for Performance Improvement purposes. Conducts appropriate and timely initial and follow-up assessment regarding patient's history, current status, acute care needs, and post acute care needs. Demonstrates Nursing judgement and clinical knowledge to determine appropriate interventions to address patient's needs and barriers to the patient's progression through the healthcare system. Documentation reflects psychosocial and medical background of patients served, including high risk screenings related to case management and proposed interventions/outcomes as indicated. Professional interventions reflect good judgment, individualized planning, critical thinking skills, and timely appropriate responses to patient's needs. Performs proactive discharge planning which includes coordinating patient/family education and the development/implementation of a safety and quality-driven post acute care plan. Coordinates/collaborates with Social Workers, Directory and other interdisciplinary team or administrative team members on ethical/ legal issues, including abuse/ neglect cases or psychiatric cases. Conducts pre-admission analysis of patient records using established criteria appropriate to the age, psychosocial and physical status of the individuals served. Verifies coverage parameters for potential acute care stay and potential ED discharge plans, keeping patient/family and physician aware of findings. Measures medical appropriateness of all proposed inpatient and OBV admissions, assessing medical validity thereof and if appropriate for acute stay, the correct admission status. Demonstrates understanding of utilization management necessity for all patient, regardless of third party payor or lack thereof. Refers cases with challenging financial or social barriers to Social workers and other assistive contacts indicated. Supports Medical Staff by regularly appraising them of appropriateness of care setting/status issues, financial coverage status, and potential alternative options for care, making recommendations accordingly. Collaborates with interdisciplinary care team and documents any actions taken or plans developed. Consults with healthcare providers, both internal and external, for care as needed and makes referrals including provisions for the continuum of care. Serves as resource for issues related to case management/social work and mentors others. Communicates with the care team to help patients move through the ED and JSMC system as smoothly and efficiently as possible Works with the interdisciplinary team to identify opportunities for process improvement and enhance quality outcomes. Utilizes an interdisciplinary approach to case management, including the physician, case management team, and care team. Provides excellent customer service and hand-off communication. Within the scope of practice, assists the organization and patients/families in issues such as: patient flow challenges, advanced directives, decisional capacity questions, psychiatric patient needs, referrals to specialty and community resources, external transfers, and end-of life issues. Supports the organization in the effort to accurately assign incoming patients to the correct attending physician and correct level of care. Proactively educates others about the Intake case management program, goals, and access. Assists in positive development, implementation, and on going monitoring of CM Intake program, assuring proactive positive communication and diligent follow-up. Establishes working relationships with patients and families, allocating increased time as needed for difficult or complex cases. Educates patient and families regarding resources available for physical and psychosocial needs of patient. Proactively includes patient and family in a)the discharge planning process if connecting with outpatient resources for use after discharge from the ED and/or b)in realistic preparation for OBV or Inpt stay, setting accurate expectations for projected LOS and prepare for discharge needs beginning at admission. Acts as a patient advocate in planning and negotiations with others, effectively representing the patient and family.
Required Skills
MINIMUM EDUCATION: Associates' Degree in Nursing minimum. Bachelors in Nsg, Business or health-care related field preferred.
REQUIRED SKILLS: BLS certification: Current BLS certification, American Heart Association, preferred.
Required Experience
MINIMUM WORK EXPERIENCE: Minimum of three years clinical experience, preferred in acute-care setting. Demonstrated understanding of continuous performance improvement focus preferred. Demonstrated excellence in customer service and communication skills.
REQUIRED LICENSES: Licensed Practical Nurses Licensed by the State of Kentucky board of Nursing preferred. LPN license in the state KY with indicated training and case management experience may be considered. CCM preferred but not required
MINIMUM EDUCATION: Associates' Degree in Nursing minimum. Bachelors in Nsg, Business or health-care related field preferred.
REQUIRED SKILLS: BLS certification: Current BLS certification, American Heart Association, preferred.