HCA, Hospital Corporation of America RN Case Manager - Case Management - Full-Time, Days (Rotating Weekends) in Portsmouth, New Hampshire
Provides Case Management functions for the organization. Completes assessments for the purpose of identifying discharge-planning needs. Provides discharge-planning services for select patient populations. Collects data to support performance improvement initiatives.
Essential Functions:* Applies rules of Severity of Illness/Intensity of Service/Discharge Screens (IS/SI/DS) consistently in evaluating medical necessity for governmental payers (Medicare/Medicaid/Champus) * Provides initial and ongoing assessments for patients/families having complex needs and/or medically complex diagnoses within 24 hours of admission or 1 business day; prioritizes needs ongoing * Demonstrates awareness of current trends that influence health care practice and assures compliance with regulatory, governmental and organizational standards * Conducts all interactions with staff, patients and members of the public with dignity and respect, keeping with institutional corporate ethics. Reflects the hospital’s values and possesses a sensitivity to the hospital’s ethical and compliance principles in activities of daily work life (ADWL). * Identifies and intervenes to coordinate care on patients in relation to appropriateness of level of care, length of stay and resource utilization issues * Collaborates with the health care team and develops treatment goals and plans interventions that assist the patient and family to resolve concerns that may arise as a result of illness, engagement in risky behavior (i.e. substance abuse), limited finances and/or physical disabilities * Refers patients who require extended care post discharge to long term care, skilled nursing and/or acute rehab facilities; once bed is found, makes all arrangements for transfer * Provides crisis and supportive counseling to enhance the patient’s and families problem solving and coping skills. Facilitates the completion of advance directives, living wills, durable power of attorney and/or guardianship * Collaborates with community agencies to provide services to assist with housing, financial, transportation, psychosocial, educational, home health, and home medical equipment needs of patients and families post discharge * Identifies, tracks and records potentially avoidable days (PAD’s); intervenes to prevent or decrease PAD’s as appropriate * Builds relationships with the hospital and external community mutually working towards the benefit of our patient’s interest * Provides ongoing education for the other members of the health care team related to ethical, psychosocial and discharge planning issues * Educates patients and families to the patient’s needs post discharge and informs them of alternatives available to meet those needs * Communicates daily with on-site reviewers to collaborate in treatment plan, goals and discharge plan * Initiates hospital issued notices of non-coverage (HINN’s) when appropriate * Documents assessments, treatment goals, interventions, outcomes and discharge plan in the patient’s medical record congruent with departmental policies * Initiates data collection regarding post-discharge referral patterns (triple space discharge log); Identifies and reports data to the Quality Management Department
Portsmouth Regionalisa 209-bed acute carehospital located in Portsmouth, NH, and is part of HCA, the nation’s largest provider of healthcare services. Portsmouth Regional Hospital serves the seacoast region’s residents in New Hampshire, Maine and Massachusetts and is one of the area’s largest employers. Portsmouth Regional Hospital is the onlyLevel II Trauma Centeron the Seacoast and one of only three in New Hampshire to earn this important distinction.
Education: Associate's degree in nursing required. NH Nursing License
Experience: 1 to 3 years of experience required. Behavioral health experience highly preferred.
Job: *Case Management
Title: RN Case Manager - Case Management - Full-Time, Days (Rotating Weekends)
Location: New Hampshire-Portsmouth-Portsmouth Regional Hospital - Portsmouth
Requisition ID: 00147-7557