Catholic Health Initiatives RN-Case Manager in LEXINGTON, Kentucky
Position Summary: Strives for excellence in patient care byassisting the patient and their families navigate the complex health caredelivery system. Facilitates and coordinates services through the building ofcollaborative relationships among the nursing staff as well as other caredisciplines. Assists the patient with their journey through the care continuumby ongoing assessment, planning and evaluation. This assessment includesadmission status, on going medical necessity assessment, planning of care,delivery and utilization of services as well as monitoring quality. Ongoinggoals include the fluid transition of the patient to the next level of care.This is done in collaboration with the healthcare team, the patient and thepatient’s family. Supports an environment of healing and wellness throughcollaboration which focuses on excellence in patient care delivery, quality anddocumentation. The Care Manager is an exemplar for compassion, acceptance,respect and empathy. Recognizes and honors nursing as a distinct discipline andsupport an environment focused on healing and wellness.
Requirements: Associates Degree in Nursing, BSNpreferred. CCM experience withInterqual/M & R or Discharge Planning preferred. Prefer 2 years recentvaried acute hospital experience. 3-5years recent varied acute hospital experience, 1 year Case Management or homehealth working with Medicare/Medicaid and other federal guidelines or 2 yearsCase Management in hospital setting and experience in discharge planning withCase Management Model. Strong clinicalbackground with a broad range of clinical experience and the ability to utilizedata and regulatory information in decision making process. Level of care criteria (i.e. interqualISD-AmM&R), Pro Criteria and quality screens. Knowledge of QA processes. Experience with screening for quality of careissues and clinical criteria.
Adequate conversationalEnglish is required in order that the individual be able to take direction frommanagement, understand how to complete job tasks, communicate adequately withpatients and co-workers as necessary, understand and follow safety guidelines,and understand the Associate Handbook and all hospital policies.
WorkingRelationships: The Nurse Case Manageris responsible to the Case Management Supervisor (or Performance ManagementManager at Berea) and does not supervise any employees. Is in daily contact with, and must demonstrateability to communicate with patients, family, multi-disciplinary teams,insurance payer’s and medical staff.
Physical Requirementsand Environmental Conditions: Positionrequires frequent interaction with all types of patients, families, physicians,hospital staff, and third party payer’s.Interaction may involve conflict and emotionally chargedsituations. Tact, diplomacy and superiorproblem solving skills are required. Afterhours and weekend call required on rotational basis. Overall PhysicalDemands: Must be able to exert up to 20pounds of force occasionally and/or up to 10 pounds of force frequently and/or negligibleamount of force consistently to move objects.Must be mobile in able to serve patients and families on theirrespective nursing units. Must be ableto perform moderately difficult manipulative skills and tasks that requirehand-eye coordination. Must be able tohear normal sounds.
Demonstrates a commitment toservice, organization values and professionalism through appropriateconduct and demeanor at all times
Adheres to and exhibits ourcore values: Reverence : Having a profound spirit of awe and respect for allcreation, shaping relationships to self, to one another and to God andacknowledging that we hold in trust all that has been given to us. Integrity : Moral wholeness, soundness, uprightness, honesty andsincerity as a basis of trustworthiness. Compassion : Feeling with others, being one with others in theirsorrows and joys, rooted in the sense of solidarity as members of thehuman community. Excellence : Outstanding achievement, merit, virtue; continuallysurpassing standards to achieve/maintain quality.
Maintains confidentiality andprotects sensitive data at all times
Adheres to organizational anddepartment specific safety standards and guidelines
Works collaboratively andsupports efforts of team members
Demonstrates exceptionalcustomer service and interacts effectively with physicians, patients,residents, visitors, staff and the broader health care community
Catholic Health Initiatives and itsorganizations are Equal Opportunity Employers
Primary Location KENTUCKY-LEXINGTON-SAINT JOSEPH HOSPITAL
Daily Schedule 8am
Scheduled Hours per 2-week Pay Period 0
Weekends Required Occasional
Req ID: 2018-R0163093
We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.