Lead Case Manager RN

Job Details

The Lead Case Manager RN utilizes advanced nursing skills and knowledge to comprehensively coordinate care for a defined patient population to facilitate patients through the continuum of care. Coordinate all aspects of discharge planning and establishes a safe discharge plan for assigned patients. In the Lead role, assists Leadership by providing clinical expertise and knowledge. Assists Department leaders in day to day departmental operations.

Job Description

Summary
The Lead Case Manager RN utilizes advanced nursing skills and knowledge to comprehensively coordinate care for a defined patient population to facilitate patients through the continuum of care. Coordinate all aspects of discharge planning and establishes a safe discharge plan for assigned patients. In the Lead role, assists Leadership by providing clinical expertise and knowledge. Assists Department leaders in day to day departmental operations.

Job Duties

• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.(Do not delete, move or over-write this statement)
• Meets with patient/family to assess needs to complete an initial Case Management Assessment per Department policy and procedure, then develops an initial discharge plan.
• Facilitates patient progression throughout the patient’s hospital stay.
• Functions as a resource for the staff in addressing discharge planning issues. Assists in removing patient progression barriers to discharge.
• Meets with patient/family to assess needs to complete an initial Case Management Assessment per Department policy and procedure, then develops an initial discharge plan.
• Advocates for the patient and family throughout the entire episode of care. Functions as a resource to facilitate communication among the healthcare team and the patient/family.
• Reviews patient’s status daily to identify issues requiring priority interventions or attention which may impact the established discharge plan.
• Reviews patient LOS/barriers data to facilitate patient’s progression during Multidisciplinary Rounds and Escalation/Outlier meetings.

Minimum Qualifications

• Bachelor’s Degree of Nursing
• 2 years case management or discharge planning experience
• Healthcare Regulatory Environment Knowledge and understanding of legislation and regulatory bodies affecting healthcare practices.
• Medical Ethics Knowledge of practices, behaviors, applicable laws, rules and regulations governing proper medical conduct.
• Patient Rights Knowledge of principles and practices associated with the rights and responsibilities of patients and caregivers.
• Discharge Planner Knowledge of the patient’s post-discharge needs and the ability to consider these needs in planning for discharge and arranging for follow-up care.
• Case Management Knowledge of procedures and resources for assisting patients and monitoring case plans for patients.
• Clinical Policies and Standards Knowledge of and ability to use industry standards, policies and procedures relevant to function and organization.
• Demonstrate effective use of conflict resolution skills as necessary to ensure timely resolution of issues.
• Demonstrate efficient prioritization and time management skills.
• Refers appropriate cases for Social Work intervention and involvement.
• Documents all relevant information in the Medical Record according to Department policies and procedures.
• Reviews patient length of stay/barriers data to facilitate patients’ progression during Multidisciplinary Rounds, Escalation/Outlier meetings.
• Delivers the MOON to observation status patients within the required timeframe (Center City).
• Ensures appropriate patients receive the second copy of the CMS IM within 2 days of discharge (Center City).
• Facilitates patient transfers to other acute care hospitals.
• Communicates with identified Department staff to initiate and facilitate referrals and authorizations for post-acute care services and any medical necessity issues.
• Refers cases and identified issues to the Physician Advisor in compliance with departmental procedures and follows up as indicated.
• Keeps supervisor informed of any issues.
• Facilitates daily patient Plan of Care Huddle Rounds functioning as the Patient Progression Leader.
• Monitors patient’s progress intervening as necessary to ensure patient progresses efficiently to discharge.
• Proactively identifies and resolves barriers to patient care and/or progression to discharge. Escalates unresolved barriers to Department Leadership.
• Participates in the completion of daily staffing, ensuring coverage for weekends and holidays.
• Makes daily assignments for specific areas.
• Attends daily hospital bed/patient safety huddles and provides follow-up on identified concerns. Communicates information to Manager/Director.
• Coordinates and supervises department specific orientation of newly hired staff with support from the Manager.
• Facilitates identified meetings in the absence of the Manager or Director.
• Provides feedback to the Manager/Director related to staff performance.
• Promotes teamwork through organizing team recognition, employee engagement activities in partnership with the Manager and Director.
• May attend campus specific meetings representing the Department in the absence of the Manager/Director.
• Coordinates Medicare discharge appeal process including providing the Detailed Notice of Discharge and follow-up with the outcome.
• Takes weekend/holiday “on call” for clinical or administrative responsibilities to address and resolve departmental issues. Escalate unresolved issues to supervisor. (JNJ Washington Township)
• Covers for the Manager in their absence.
• RN - Licensed Registered Nurse_PA - State of Pennsylvania or
• RN - Licensed Registered Nurse_NJ - State of New Jersey

Additional Qualifications

Physical Demands
Lift and carry 40-50 lbs. Examples: Push/pull patients on bed, stretcher (requires 29 lbs. push force), lateral transfers up to 50 lbs. of the patient's weight. Frequent to continuous standing/walking. Patient transporters can walk 8-10 miles per shift. *Patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Thomas Jefferson University Hospitals, Inc.

Primary Location Address

111 S 11th Street, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educa­tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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