Coordinate, delegate and provide care of patients. Accountable to lead, supervise, manage and carry out patient care decisions and care. Plans and delivers patient-focused care in partnership with physician, interdisciplinary team and patient/family.
Plans, develops, assesses, and evaluates care provided to members.
In conjunction with physicians, evaluates and develops discharge plans, recommends alternative levels of care, and ensures compliance with federal, state, and local requirements.
Develops and maintains case management policies and procedures.
Coordinates, directs, and performs concurrent and retrospective reviews, and monitors level and quality of care.
Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining all authorizations/ approvals as needed for outside services for patients/families.
Consults with physicians, health care providers, and discharge planning and outside agencies regarding continued care/treatment or hospitalization.
Encourages members to follow plans of care (e.g., drug therapy, physical therapy).
Makes referrals to appropriate community services.
Identifies and recommends opportunities for cost savings and improving the quality of care across the continuum.
Develops and collects data, and trends utilization of health care resources.
Interprets regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, contract providers, and outside agencies.
Coordinates transmission of clinical and benefit treatment to patients, families and outside agencies.
Graduation from an accredited School of Nursing.
Emergency Department experience preferred.
Current state licensure as a Registered Nurse.
Current CPR/BLS Certification required.
Specialty certifications preferred (i.e., ACLS/PALS/TNCC)
Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times
Adheres to and exhibits our core values:
Reverence : Having a profound spirit of awe and respect for all creation, shaping relationships to self, to one another and to God and acknowledging that we hold in trust all that has been given to us.
Integrity : Moral wholeness, soundness, uprightness, honesty and sincerity as a basis of trustworthiness.
Compassion : Feeling with others, being one with others in their sorrows and joys, rooted in the sense of solidarity as members of the human community.
Excellence : Outstanding achievement, merit, virtue; continually surpassing standards to achieve/maintain quality.
Maintains confidentiality and protects sensitive data at all times
Adheres to organizational and department specific safety standards and guidelines
Works collaboratively and supports efforts of team members
Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community
Catholic Health Initiatives and its organizations are Equal Opportunity Employers.
For Catholic Health Initiatives (CHI), returning sick people to good health is more than a business -- it's a mission. Formed in 1996...