RN Case Manager, University Hospital

Overview:

We are Hiring at University Hospital

Location: 530 South Jackson St, Louisville, KY 40202

Shift Options: Full Time, Varies

About UofL Health

UofL Health is a fully integrated regional academic health system with nine hospitals, four medical centers, Brown Cancer Center, Eye Institute, nearly 200 physician practice locations, and more than 1,000 providers in Louisville and the surrounding counties, including southern Indiana. Additional access to UofL Health is provided through a partnership with Carroll County Memorial Hospital.

Affiliated with the University of Louisville School of Medicine, UofL Health is committed to providing patients with access to the most advanced care available. This includes clinical trials, collaboration on research and the development of new technologies to both save and improve lives. With more than 14,000 team members – physicians, surgeons, nurses, pharmacists and other highly-skilled health care professionals, UofL Health is focused on one mission: to transform the health of communities we serve through compassionate, innovative, patient-centered care. For more information on UofL Health, go to www.UofLHealth.org.

Our Mission

As an academic health care system, we will transform the health of the communities we serve through compassionate, innovative, patient-centered care.

Under the direction of the Manager or Director of Care Coordination or CNO, the RN Case Manager performs activities which support the Care Coordination Department including:

• Promotes optimal management of clinical resources by conducting timely initial admission assessments based on clinical indicators and anticipated service needs for appropriate level of hospital care; Validates patient demographics and payor source

• Utilizes and contributes to the development of the multidisciplinary clinical assessment of patients on an on-going basis during the patient’s admission to ensure the quality and appropriateness of patient care

• Implements, reassesses, and evaluates patient condition and coordinates plan of care daily;  Develops patient specific plan of care based on the individual needs of the patients, conversations with providers and other staff, and documentation in electronic medical record (EMR.) Ensures updated plan of care is documented in the EMR

• Coordinates the discharge needs of patients with necessary internal and external providers while protecting patient information

• Performs timely, professional, and appropriate documentation as reflected in the Quality Review Audit process

• Advocates for patient/family needs in a respectful, non-judgmental, and confidential manner

• Serves as a liaison or facilitator for the patient and interdisciplinary healthcare team in the management of unusual or questions cases. Educates the healthcare team about the role of the RN: Case Manager.  Is accessible to the healthcare team as a resource.

• Appropriately refers cases to manager/director of care coordination, CAO, or medical director when intensity of service or severity of illness is not present and is unable to be resolved

• Ensure delivery of Discharge Medicare Important Message (IM) and Medicare Outpatient Observation Notice (MOON), where applicable

• Acknowledges, addresses, and completes are Consults to Case Management on respective units in EMR

Other Functions:

• Works collaboratively with social workers to identify social and financial barriers and community resources

• Completes referrals to Social Worker for patients with high-risk indicators

• Attends monthly departmental staff communications meetings. Serves as an active member of committees, as needed, which may include a variety of projects or topics

• Enhances professional growth and development through participation in educational programs, reading current literature, attending in-service meetings and workshops that are related to assigned areas of responsibility. Assumes responsibility of growth and development, maintains competency in care management principles

• Educates physicians, patients, and staff with regards to payors, financial issues, documentation, and potential compliance issues

• Serves as a resource to physicians for clinical management and financial issues.  Assists the providers with promoting efficiencies in the care delivery system and reducing/ eliminating barriers to efficient/effective service

• Maintains compliance with all company policies, procedures and standards of conduct

• Complies with HIPAA privacy and security requirements to maintain confidentiality at all times

• Performs other duties as assigned

Required Qualifications

• Licensed or eligible for license in Kentucky
• Basic Life Support (BLS) accredited by the American Heart Association (AHA)
• Bachelor’s degree from accredited college or University or RN with a Bachelors Degree in Business or Health Care Administration preferred. Will consider RN with A.D.N. if actively pursuing BSN, with BSN completion required within 2 years of hire. 
• Must have 2-3 years experience as an RN plus utilization management or discharge planning/case management experience. Minimum two years experience performing utilization review and/or quality assurance activities in an acute care facility or HMO/PPO/PRO preferred. Must be able to adjust priorities quickly, organize multiple tasks simultaneously, and work interdependently with many levels of staff. Attention to detail; strong organizational, interpersonal and communication skills; and innovative problem solving skills required. Must be able to adjust work hours depending on depending upon departmental needs as determined by the director or manager.

Preferred Qualifications

• Certification in a nursing specialty area or CCM

Benefits & Perks

• Competitive Pay & Benefits Options
• Paid Vacation, Sick days, and Holidays
• Free tuition to UofL for Part- and Full-time employees for Child/Spouse/Domestic Partner
• 401K with Employer Match

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