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 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.
