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
#EXPRN
Job Role Summary
The weekend Case Manager and Discharge Coordinator serves as the overall coordinator of care, collaborating in tandem with Social Work counterpart, Physicians, Interdisciplinary Team, Nursing, and patients/families to provide seamless and efficient service for the trauma and orthopedic teams. This position is responsible for managing each patient's plan of care, monitoring for appropriate resource utilization, and coordinating the patient's discharge plan. The schedule for this position will be three weekends per month with one weekend off. The incumbent will work 40 hrs. per week with their hours focused on weekends and making up the remaining hours during the week to reach 40 total. The one week per month when the weekend is not worked, all 40 hrs. will be obtained during the standard work week.
Essential Functions and Responsibilities
Overall coordinator of care, collaborating with Social Work counterpart, Physicians, Interdisciplinary Team, Nursing, and patients/families to provide efficient services for the trauma and orthopedic teams
Manages each patient's plan of care, monitoring for appropriate resource utilization, and coordinating the patient's discharge plan
Coordinates the patient's care,serving as a patient advocate, delivering efficient health care
Communicates with Physicians, Physician extenders (Nurse Practitioners, Physician Assistants), Interdisciplinary Team, Nursing, and patients/families to ensure timely patient progression through the episode/plan of care
Resolves problems impeding diagnostic or treatment progress and proactively resolves delays to discharge
Utilizes conflict resolution, critical thinking, and negotiation skills to ensure timely resolution of issues
Identify strategies to reduce the length of stay and resource consumption within the targeted population
Personally interview patients and other relevant sources to collect information in an attempt to identify individual needs and develop a comprehensive plan of care that addresses medical, social, and financial needs
Collaborate with the teams, Transition Support leadership and Medical Director to identify cases that require special intervention
Documents avoidable days and quality indicators as appropriate
Actively participates in creating/planning an action-oriented and time specific plan of care
Assures adherence to clinical pathways/protocols and the appropriate use of clinical tools through collaboration with Physicians, Interdisciplinary Team, Nursing, and unit staff
Continually monitor patients 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
Evaluates at appropriate intervals that the quality of healthcare to each patient is delivered in an efficient manner throughout the patient's episode of care
Educate rotating surgical residents on case management duties and new updates to maintain compliance
May conduct or provide oversight of the initial admission review, utilizing InterQual criteria, within 24 - 72 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.
Applies InterQual criteria to complete concurrent reviews as indicated by payer or ~ every 72 hours.
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
Coordinates with Social Work regarding Financial Counseling and or Case Enhancement Specialist to assure private payer pre-certification/authorization for services is obtained when required
Addresses private payer denials
Evaluates the active funding for each patient and communicates with Financial Counseling to facilitate the initiation of appropriate funding applications
Addresses financial barriers to healthcare/medical compliance with the patients/families when indicated
Coordinates discharge planning for assigned patient with Social Work
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
Job Requirements
Active RN license in the State of Indiana, or ability to obtain licensure through application
Minimum of 5 years of clinical nursing experience
Knowledge, Skills & Abilities
Demonstration of Case Management knowledge and managed care processes
Competency in:
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.
