Inpatient Nurse Care Manager - Elgin , IL - Case Management

Company: Advocate Sherman Hospital
Location: Elgin
Posted on: November 19, 2023

Job Description:

Inpatient Nurse Care Manager - Elgin , ILInpatient Care Manager Sherman HospitalM-F 8am to 4:30 Weekend and Holiday RotationThe Care Manager (CM) is accountable for proactive coordination and timely transition of assigned patients to the most appropriate level of care along the continuum. This position will impact key results such as achieving top decile performance in length of stay, cost efficient resource utilization, preventing readmissions and unnecessary emergency room visits. The CM will work collaboratively with Physicians, Nursing, members of the multidisciplinary team, Outpatient Enterprise Care Management, Home Care and PCP offices as well as other resources external to the organizationMajor Responsibilities:---Assists in the development, implementation, and evaluation of a multidisciplinary, individualized patient plan of care that includes an appropriate transition plano ------1)Performs rounds on assigned patients to coordinate care through assessing needs, communicating, evaluating, and making recommendations to the plan of care, as needed.o --------2)Evaluates the plan of care for individual patients and/or patient populations, utilizing nationally recognized medical necessity criteria, to assure that care is based on accepted standards, evidence based practice, and current research.o --------3)Acts as a liaison by collaborating and communicating with the physician, patient, family, and other members of the healthcare team.o --------4)Identifies the need for, arranges, and participates in family care conferences, as needed.o --------5)Initiates referrals to other internal and external healthcare providers, after collaboration with the physician, to assure timely progression and continuity of care, i.e. physical therapy, outpatient ECM, home care, palliative care, hospice, etc.o --------6)Works collaboratively with the care management team on complex cases to ensure that identifiable needs are addressed prior to transition from the hospital setting.o --------7)Assesses risk of readmission for specified patient populations and initiates assigned interventions that will enhance the patient's ability to successfully transition along the care continuumo --------8)Serves as a resource for alternate venues of care delivery, and works proactively to prevent duplication, fragmentation, and use of unnecessary resources.o --------9)Serves as a resource for the initiation, development, and implementation of pathways, algorithms, standards and guidelines to guide the progression of care.Communicates with physicians, patients, families, and other members of the healthcare team to coordinate transition planning.--------1)Assesses the needs of assigned patients for transition planning. Works collaboratively with the social worker and other disciplines to ensure a safe, appropriate, and timely transition to the next level of care, taking into consideration the patient's available resources.o --------2)Identifies barriers early in the patient's stay, formulating a plan with the patient, family, internal and external members of the healthcare team, payers, and community resources.o --------3)Makes appropriate referrals to social services, ancillary departments, enterprise case management, and other outside agencieso --------4)Communicates transition plans with other members of the healthcare team.Works with physicians and other members of the healthcare team to ensure efficient utilization of multidisciplinary resourceso --------1)Works closely with the physician and nursing team to ensure that all activities related to the plan of care are completed in a timely manner.o --------2)Evaluates scheduling of patient's procedures to provide timely customer focused services, proactively intervening to expedite testing, as needed.o --------3)Identifies and communicates with the physician, opportunities for tests, procedures, and therapies to be completed on an outpatient basis.o --------4)Interacts with internal and external members of the healthcare team to assure appropriate utilization of resources and efficient movement of the patient through the care continuum.Identifies variances from established utilization management criteria, plans of care, pathways, algorithms, and guidelines and facilitates the development of action plans.o --------1)Utilizes the designated medical necessity screening criteria to identify, document and communicate the appropriate level of care, continued stay, and length of stay variances.o --------2)Collects avoidable day data and other pertinent information for data analysiso --------3)Identifies and reports significant variances and/or service delays from established plans of care, inappropriate level of care, and complex case concerns to the Medical Director/Physician Advisor of care management.o --------4)Actively participates in clinical case review with the Medical Director/Physician Advisor and other leaders of the care management department.o --------5)Reports data and elevates barriers to appropriate leadership for information and resolution, which may include, but not limited to risk management, infection control/prevention, and performance improvement.o --------6)Promotes patient safety by reporting of issues through established channels and participating, as requested in safety initiatives.o --------7)Represents the care management department on various teams and performance improvement activities addressing opportunities to improve clinical progression and coordination of care and strengthen evidence-based practice.Responsible for Professional Growtho --------1)Maintains knowledge of current standards of care via literature review and participation in educational offerings.o --------2)Completes required contact hours based on licensure and certification.Licensure:

• • Nurse, Registered (RN)Education/Experience Required:
    • • New Hires/transfers: BSN required as of 1/1/2016. Prior to 1/1/2016: must be enrolled in BSN program by 11/4/16, must be complete by 1/1/20 3-4 years' recent experience in care management or 5 years relevant clinical experience. Knowledge, Skills & Abilities Required:
        • • --- Effective interpersonal communication skills- verbal and written. --- Ability to work with diverse teams and individuals, team player --- Ability to prioritize work --- Utilization of critical thinking in timely decision-making --- Basic computer skills
          • Current RN license in the State of Illinois Physical Requirements and Working Conditions:
            • • --- Embraces changing paradigm for enterprise care management and the need to act in a more coordinated and integrated fashion across the enterprise --- Willing to be accountable for KRAs related to managing LOS, resource utilization (cost), readmissions. --- Ability to work in a fast paced environment with established time constraints and in difficult situations --- Flexible hours according to customer needs --- Ability to prioritize independently and respond to multiple simultaneous requests --- Ability to recognize needs and behaviors of specific age groups of assigned patients --- Ability to lift weight up to 20 pounds --- May be exposed to hazardous material and life-threatening diseases
              • If position has direct patient care or direct patient contact the following lifting requirement supersedes any previous lifting requirement effective 06/01/2015. Ability to lift up to 35 pounds without assistance. For patient lifts of over 35 pounds, or when patient is unable to assist with the lift, patient handling equipment is expected to be used, with at least one other associate, when available. Unique patient lifting/movement situations will be assessed on a case-by-case basis.This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Keywords: Advocate Sherman Hospital, Elgin , Inpatient Nurse Care Manager - Elgin , IL - Case Management, Executive , Elgin, Illinois