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Luminis Health · 4 months ago

Case Manager (RN) - PRN/Supplemental

Lanham, MD

Full-time

Onsite

Mid Level

$35/hr - $50/hr

3+ years exp

Luminis Health is a healthcare organization seeking a Case Manager (RN) to provide coordination of care for patients. The role involves assessing patient needs, implementing care strategies, and ensuring safe transitions across the healthcare continuum.

Health CareMedicalNon Profit

Responsibilities

Identifies and prioritizes patient in need of care management services, using a holistic approach inclusive of biopsychosocial, functional, cultural, spiritual, and financial factors; uses a multi disciplinary approach to assess/plan for care needs

Identifies and implements strategies such as motivational interviewing to promote patient engagement, self-care, treatment adherence, and optimal levels of health and well-being

Utilizes evidenced based guidelines (such as InterQual or other agreed upon evidenced based guidelines) to promote quality care, decrease variation and mitigate waste. Verifies appropriate level of care; enters clinical review and authorized days in Epic; documents actions to avoid denied days; refers cases to Physician Advisor as appropriate

Manages observation stay patients assertively and ensures timely testing, treatment and conversion to inpatient status or discharge

Develops and coordinates transition plans for patients transitioned to home with home health, community care coordination program, Hospice or Palliative care, home infusion and routine sub-acute and skilled post-acute providers; completes all necessary documentation and necessary handovers. Involves and prepares patients and families for transition from the ED, Peds, Clatanoff or Observation unit as indicated

Maintains clear and concise documentation in each patient record to reflect physical and functional limitations, psychosocial characteristics, educational needs of patient & family, family/social support systems, financial, economic, and transition needs. Initiates referrals to disciplines as indicated

Participates in nursing unit and department clinical outcome projects as well as process improvement initiatives of care management

Identifies potential or current patient situations which require referral to other members of the health care team such as infection control, risk management, or quality management. Assures plan of care is adjusted as appropriate and that follow-up occurs. Keep leadership abreast of potential issues

Utilizes all risk and predictive analytic tools such as the readmission risk tool. Applies tailored interventions to mitigate potential barriers or risk, prolonged unnecessary hospitalization and readmission prevention

Maintains compliance with all regulatory standards (CMS, commercial insurers etc)

Qualification

Registered Nurse LicenseCare CoordinationClinical ExperienceEvidence-Based GuidelinesMotivational InterviewingPatient EngagementDocumentation SkillsTeam Collaboration