Primary Function/General Purpose of Position
Responsible for providing coordination of care for patients to support safe, seamless, timely transitions across the continuum. Utilizing a collaborative process, the care manager will identify, assess, plan, implement and evaluate the options and services required to meet an individual’s health and health related needs, including social- determinants that affect ones’ overall wellbeing. The care manager promotes the right resources, at the right time and at the right level of care and is responsible for engaging and supporting patients that would benefit from and need care management services.
This is a PRN position at Maryview Medical Center
Licensing/ Certification
Acute Registered Nurse (RN) (required)
BLS Basic Life Support – American Heart Association (required)
Certification in Case Management preferred and required withing three years of hire.
Education
Baccalaureate degree preferred and required withing 5 years of hire.
Work Experience
One to three years nursing experience required. Three to five years nursing experience preferred.
Training
EPIC Electronic Health Record (preferred)
Microsoft Excel / Teams (preferred)
Essential Job Functions
Identifies and prioritizes patients in need of care management services, using a holistic approach inclusive of biopsychosocial, functional, cultural, spiritual, and financial factors. Plans with the patient, family, other caregivers, and other members of the healthcare team to maximize health care responses, quality, and cost-effective outcomes. Completes all necessary care management documentation and handovers. Monitors effectiveness of the plan of care and collaborates with the care team, patient, family/caregiver to revise as indicated. Serves as a patient advocate, as well as an organizational advocate.
Follows leading, standardized practices and processes related to LOS/LOC management, readmission prevention, supports denial prevention related to medical necessity through proactive progression of care and addressing/removing barriers, daily team rounding informing the care team of risk of readmission and discussing LOS actual vs. goal and plan for the day, stay and way with a projected transition date. Develops, coordinates, and monitors strategies for obtaining resources required for safe and timely care transitions.
Verifies patient’s needs for acute level of care, collaborating with utilization management nurse to prevent potential denials. The care manager will address when patient is not receiving evidenced based care and escalate to care management leader and/or physician champion at the facility level to resolve barriers.
Supports and promotes assertive proactive care with Observation stay patients and helps in removing barriers related to achieving timely testing and treatment. Works in collaboration partners to help remove barriers to get patients converted to appropriate classification when appropriate and guided by physician, ensuring CC 44 is delivered when indicated, also closing the loop on CC 44 to ensure tracking and trending.
Maintains clear, concise, and timely documentation in each patient record to reflect physical and functional limitations, psychosocial characteristics, educational needs of patient and family/caregiver, financial, economic, and transition needs. Initiates referrals to disciplines as indicated. Documentation will reflect plan of care to address post-hospital care needs and evidence of patient, family/caregiver involvement in planning.
Participates in nursing unit and department clinical outcome projects as well as process improvement initiatives within care management. Works collaboratively with peers to achieve department goals and daily work as evidenced by appropriate and timely communication which is respectful and clear. Sensitive to workload of peers and shares responsibilities, fills in, and offers help promoting team-based approach in order to accomplish work. Understands data relative to patient population and utilizes information to improve quality and reduce cost.
The care manager shall support and follow compliance rules and regulations and Conditions of Participation for DC Planning and Utilization Review, and address opportunities or potential concerns with leadership. Identifies potential or current patient situations which require referral to other members of the health care team. Keeps leadership abreast of potential issues.
The Care Manager will demonstrate commitment to work partners to help each other reach mutual goals and learn from each other. Demonstrates actions and behaviors that consistently promote trust, respect, a positive attitude and promote team morale.
Care managers proactively engage and educate members of the medical staff and the nursing staff to help them better understand the nuances of transition management, safe alternatives to acute care, proactive progression of care, reimbursement, and the regulatory landscape.
Attends appropriate clinical and professional organizations, workshops, and meetings, stays abreast of community resources available to facilitate safe patient transitions of care. Remains current on clinical advancements related to primary patient population, proactively seeks to understand areas/roles outside of immediate area/role within department.
This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.
Patient Population - Mark selections with an "X":
The following must be included in all position descriptions that involve direct or indirect patient care. This is a Joint Commission requirement. Also, select the age of the patient population served:
x Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.
x Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.
x Neonates (0-4 weeks)
x Infant (1-12 months)
x Pediatrics (1-12 years)
x Adolescents (13-17 years)
x Adults (18-64 years)
x Geriatrics (65 years and older)
Not applicable to this position
Working Conditions
Office and clinical setting
May be exposed to infections and contagious diseases.
Regularly exposed to the risk of blood borne diseases.
Contact with patients/families/physicians under wide variety of circumstances.
Exposed to unpleasant elements (accidents, injuries, and illness)
Subject to varying and unpredictable situations.
Occasionally subject to irregular hours.
Will be asked to provide weekend coverage.
Handles emergency crisis situations.
Frequently encounter emotional strain when providing guidance in crisis situations.
Physical Requirements/Hazards
Complete the following charts regarding physical requirements and hazards.
Mark an X in the “Some” column if an incumbent will perform this activity less than 33% of the time; mark an X in the “Freq” column if an incumbent will perform this activity more than 33% of the time.
Fill in the appropriate % of time in the “Work Position” column.
Activity
Some
Freq
Work Position %
Lift
0-50 lbs.
X
Sitting
33%
Carry
0-50 lbs.
X
Walking
33%
Push
0-50 lbs.
X
Standing
33%
Pull
0-50 lbs.
X
Stoop, Kneel
Crawl
Climb
Balance
Physical Requirements
Hazards
Mark with an X if this is a physical requirement for this job.
Mark with an X if this is a potential hazard for this job.
X
Manual dexterity (eye/hand coordination)
X
Use of Latex Gloves
X
Perform shift work
X
Exposure to toxic/caustic/chemicals/detergents
Maneuver weight of patients
X
Exposure to moving mechanical parts
X
Hear alarms/telephone/tape recorder
X
Exposure to dust/fumes
X
Reach above shoulder
X
Exposure to potential electrical shock
X
Repetitive arm/hand movements
X
Exposure to x ray/electromagnetic energy
X
Finger Dexterity
X
Exposure to high pitched noises
Color Vision
X
Exposure to communicable diseases
X
Acuity – far
X
Blood born pathogen exposure
X
Acuity – near
X
Gaseous risk exposure
X
Depth perception
X
On Call
OFFICE EQUIPMENT USED
Computer, Telephone, Copier, Printer, Scanner, Fax, Pager
Bon Secours Mission, Values, Customer Orientation and Continuous Quality Improvement Focus
It is the responsibility of all employees to learn and utilize continuous quality improvement principles in their daily work.
All employees are responsible for extending the mission and values of the Sisters of Bon Secours by understanding each customer, treating each patient, staff member, and community in a dignified manner with respect, kindness, and understanding and subscribing to the organization's commitment to quality and service.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification and are not to be construed as an exhaustive list of all job duties. This document does not create an employment contract, and employment with Bon Secours Virginia is "at will."
Many of our opportunities reward* your hard work with:
Comprehensive, affordable medical, dental and vision plans
Prescription drug coverage
Flexible spending accounts
Life insurance w/AD&D
Employer contributions to retirement savings plan when eligible
Paid time off
Educational Assistance
And much more
*Benefits offerings vary according to employment status
All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com