RN Care Manager at UnityPoint Health

Waterloo, Iowa, United States -

Full Time

Start Date

Immediate

Expiry Date

23 Jul, 26

Salary

0.0

Posted On

24 Apr, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Care management, Discharge planning, Utilization management, Patient assessment, Interdisciplinary collaboration, Clinical documentation, Medicare regulations, Health education, Patient advocacy, Electronic medical records, Care coordination, Resource utilization, Communication, Organizational skills, Evidence-based practice

Industry

Description

Overview RN Care Manager Allen Hospital Full-time, Monday-Friday 8a-4:30pm 7 weekends/year and one holiday/year Coordinates patient care across the acute care continuum by partnering with physicians, nursing, social services, and ancillary teams to develop and implement an interdisciplinary plan of care. Conducts admission and ongoing assessments, monitors clinical progress and resource utilization, and leads safe transitions of care, including discharge planning and referrals to community services. Educates patients and families, addresses psychosocial and social determinants of health barriers, and collaborates with Utilization Management regarding level of care considerations. Serves as the central communicator to promote collaboration, continuity, and achievement of defined outcomes such as reduced readmissions and optimized length of stay. Why UnityPoint Health? At UnityPoint Health, you matter. We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row for our commitment to our team members. Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in. Here are just a few: Expect paid time off, parental leave, 401K matching and an employee recognition program. Dental and health insurance, paid holidays, short and long-term disability and more. We even offer pet insurance for your four-legged family members. Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance to help you grow your family. With a collective goal to champion a culture of belonging where everyone feels valued and respected, we honor the ways people are unique and embrace what brings us together. And, we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience. Find a fulfilling career and make a difference with UnityPoint Health. Responsibilities Assumes responsibility for developing a plan of care including a discharge plan that is mutually established with the patient and family, with identified goals and expectations reviewed to identify and verify priorities Facilitates communication with provider and healthcare team regarding current level of care status, plan of care, focus goals, progress towards goals and anticipated discharge needs Facilitates communication with patient and family regarding current level of care status, expected length of stay, plan of care, focus goals, progress towards goals and anticipated discharge needs Provides explanations to patients and families regarding level of care status and implications of observation status versus inpatient status, as appropriate. Recognizes potential and actual post-discharge needs and makes appropriate referrals to social work to enhance continuity of care. Assists in arranging post-discharge services, including contact with insurance company for possible pre-authorization requirements. Coordinates discharge plan with provider, social services, healthcare team, patient and family. Communicates the discharge plan to the primary nurse and healthcare team through verbal updates and handoff tools. Completes discharge planning documentation in the electronic medical record. Helps with coordinating placement with Medicare Nex Generation patients and following Millennium Care Guidelines criteria for length of stay. Provides oversight for utilization of evidence-based care for patient populations. Assesses need for patient and family education. Participates with the healthcare team in identifying and providing health teaching and counseling, as appropriate. Facilitates referrals to appropriate resources. Multidisciplinary patient care charting is done concurrently as care is provided to assure that goals of care and discharge planning activities are concurrently accessible to the healthcare team. Maintains knowledge of utilization management criteria and communicates with Utilization Review Assistant to ensure medical necessity and appropriate patient class for hospital stay. Assesses patient for Level of Care. Performs initial screening review for level of care in Interqual to determine if patient meets admission criteria. Ensures that ordered diagnostic tests, procedures and treatments are pre-authorized based on payer requirements and scheduling is coordinated for efficiency. Provides level of care and length of stay coaching and guidance to providers in all health care settings. Collaborates with the multidisciplinary healthcare team to ensure the delivery of high quality, evidence-based care. Collaborates closely with Social Services to facilitate discharge planning activities. Qualifications Completion of an accredited nursing program. Baccalaureate degree in nursing preferred. Two years of registered nurse experience. Three years’ experience in a clinical setting preferred with recognized knowledge and expertise in caring for specificpatient populations preferred. Current Iowa nursing licensure. Valid driver’s license when driving any vehicle for work-related reasons. Must be able to successfully complete a basic computer course through in-hospital training. Must successfully complete in-hospital orientation and competencies. Demonstrates skill, organization, and efficiency in performing required activities. Must have knowledge of Medicare Regulations and familiarity with Professional Review Organization regulations. Must have excellent oral and written communication skills with providers, payers, and consultants with the ability to negotiate and establish effective working relationships with members of the healthcare team. Knowledge of prospective payment systems, QIO activities, federal and state rules and regulations. Requires exceptional organizational skills with attention to details in order to meet deadlines independently. A spirit of inquiry is encouraged and supported.

Responsibilities

Coordinates patient care across the acute care continuum by developing interdisciplinary plans and facilitating safe transitions. Manages utilization review, discharge planning, and communication between patients, families, and the healthcare team.