Case Manager RN
Eskenazi Health

Job Info

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Division:Eskenazi Health

Sub-Division:Hospital

Req ID:9366

Schedule:Full Time

Shift:Days

Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 327-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus as well as at 10 Eskenazi Health Center sites located throughout Indianapolis.

FLSA Status

Exempt

Job Role Summary

The Case Manager, RN is responsible for managing each patient's plan of care, monitoring for appropriate resource utilization, and coordinating the patient's discharge plan.

Essential Functions and Responsibilities

• Proactively contributes to Eskenazi Health mission: Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County. Models Eskenazi Health values of Professionalism, Respect, Innovation, Development, and Excellence
• Serves as the overall coordinator of care, collaborating with Social Work counterpart, Physicians, Interdisciplinary Team, Nursing, and patients/families to provide efficient services for those within their assignment
• Responsible for managing each patient's plan of care, monitoring for appropriate resource utilization, and coordinating the patient's discharge plan
• Serves as a patient advocate, delivering quality efficient health care

Case Management:

• Coordinates/aids the patient's care across the continuum
• Collaborates/retains active communication with Physicians, Interdisciplinary Team, Nursing, and patients/families to ensure timely patient progression through the +plan of care
• Addresses/resolves problems impeding diagnostic or treatment progress
• Proactively identifies and resolves delays to discharge
• Utilizes conflict resolution, critical thinking, and negotiation skills to ensure timely resolution of issues
• Identifies strategies to reduce the length of stay and resource consumption within the targeted population
• Assesses through personally interviewing patients and any other relevant sources to collect specific information in an attempt to identify individual needs and to develop a comprehensive plan of care that addresses medical, social, and financial needs
• Collaborates with Transition Support Leadership and the Physician Advisor to identify cases that require special intervention
• Documents avoidable days and quality indicators as appropriate
• Actively participates in creating an action-oriented and time specific plan of care
• Continually reassesses and monitors patient for change in condition warranting initiation of a clinical pathway, alteration in plan of care, or change in care acuity in an attempt to determine the effectiveness of the care plan

Utilization Review:

• Conducts/ provides oversight of the initial admission review, utilizing appropriate criteria, within 24 hours of the patient's admission to the hospital to ensure appropriateness of the assigned level of care and timely implementation of the treatment plan when appropriate

Financial Assessment:

• Educates Physicians, Interdisciplinary Team, and Nursing regarding payer sources and the role this plays in discharge planning
• Communicates as necessary with the on-site private payer/managed care Case Managers
• Addresses private payer denials as appropriate
• Evaluates the active funding for each patient and communicates with Financial Counseling/Med Assist to facilitate the initiation of appropriate funding applications
• Addresses financial barriers to healthcare/medical compliance with the patients/families when indicated

Social Assessment/Discharge Planning:

• Oversees all discharges for assigned patients and collaborates closely with Social Work for discharge planning
• Facilitates discharges to post-acute services such as LTACs, Skilled Nursing Facilities, or Nursing Homes and discharge planning including Home Health Care and durable medical equipment
• Documents relevant Case Management Process and discharge planning information in medical record appropriately

Job Requirements

• Current Indiana RN required
• Minimum of 2 years health care experience; 2 years of clinical nursing experience preferred

Knowledge, Skills & Abilities

• Must demonstrate knowledge of the Case Management, patient education and managed care processes
• Demonstrates effective communication skills and knowledge of disease processes and normal growth and development for all age groups, in order to ascertain an accurate understanding of the patient's symptomology
• Competency in the following areas required:
  • Interpersonal, written/verbal communication, and negotiation skills
  • Diplomacy, flexibility, and professionalism
  • Cohesive networking with the Interdisciplinary Team

Accredited by The Joint Commission and named one of the nation's 150 best places to work by Becker's Hospital Review for four consecutive years and Forbes list of best places to work for women, and Forbes list of America's best midsize employers' Eskenazi Health's programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city's primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana, the first community mental health center in Indiana and the Eskenazi Health Center Primary Care - Center of Excellence in Women's Health, just to name a few.

Nearest Major Market: Indianapolis

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