Case Manager

Summary: Reports to the Manager or Director of Case Management. Provides coordinated care support to facilitate and expedite patient care services. Participates in daily rounds and collaborates with the clinical healthcare team across the patient care continuum to include preadmission and post‑hospital discharge. As a member of that team, shares responsibility for the implementation of the discharge plan; ensures efficient and effective delivery of patient care services through the appropriate utilization of healthcare resources. Responsibilities Partner with medical staff and other members of the healthcare team in collaboration with the patient/family to facilitate the plan of care for a defined patient population across the continuum of care. Identify a high‑risk patient population within the caseload for care management assessment, screening and target interventions in conjunction with the healthcare team within one business day of patient admission. Participate in daily care rounds to evaluate and facilitate development and implementation of the discharge planning process. Develop the initial patient discharge plan and review it with patient, family members and other members of the interdisciplinary team. Reassess the discharge plan daily during collaborative care rounds. Proactively build post‑hospital referrals and send them to the Transition Care Coordinator when indicated to facilitate timely discharge. Deliver Important Message follow‑up notices to all Medicare patients according to CMS regulations. Follow CMS and DOH regulations in relationship to discharge guidelines and patient rights. Coordinate length of stay with the physician care team and patient. Inform team of insurance qualifiers that may affect the discharge plan. Discuss approaching discharge readiness of patients. Identify and assess readmitted patients and complex patients in collaboration with the healthcare team to coordinate discharge. Advocate for the patient and advise the patient regarding financial implications of their discharge plan when coordinating care. Communicate the discharge plan, including post‑facility acceptance, to patients, families and all members of the care team. Document final discharge disposition in progress notes. Develop appropriate patient care reports to ensure safe patient handovers occur when a patient is transferred from one area to another. Provide care plan direction for the advancement of a patient care delivery system which supports managed care strategies and decreases readmission risk. Act as a change agent by identifying opportunities to improve patient flow and reduce service delays through problem resolution and follow‑up. Demonstrate a fundamental grounding in nursing theory and practice with a clinical background within a defined content area. Remain current on the latest concepts, techniques and methods relative to the service area. Demonstrate knowledge of federal and state rules and regulations. Participate in departmental and/or interdepartmental quality improvement activities as requested. Participate in orientation of new staff as requested. Participate in ongoing education‑related professional activities and affiliations to maintain an advanced level of knowledge of patient care services, third‑party payer and managed care requirements and case management. Minimum Qualifications Licensure as a Registered Nurse in the State of Rhode Island by the Rhode Island Board of Nursing or licensure as a Registered Nurse in accordance with the Nurse Licensure Compact agreement of the National Council of State Boards of Nursing. Graduate of a School of Nursing with current license to practice as a Registered Nurse in the State of Rhode Island. Bachelor’s Degree required. Certification in Case Management by a nationally recognized organization preferred or to be obtained within one year of hire. AHA BLS provider mandatory. Experience Three years of clinical experience with recent experience in case management, community case management, patient navigation, or discharge planning is strongly preferred. Strong analytical and interpersonal skills required to communicate daily with healthcare professionals, patients and families. Proficient in Microsoft Office, email, Outlook calendar, and basic keyboarding skills. Work Environment and Physical Requirements General hospital environment with occasional stressful conditions associated with patient care. Exposure to blood‑borne pathogens minimized and controlled by adherence to Hospital Infection Control policy and procedures. Ability to make hospital rounds through various patient care areas by walking or other mobile means. Visual acuity and finger dexterity needed to review and carry medical records, navigate automated system screens and type on a typical computer terminal keyboard. Lifting up to 10 pounds may be necessary to transport items from one care unit to the next. Pay Range $90,417.60 - $146,640.00 Equal Employment Opportunity Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment. Location Rhode Island Hospital – 593 Eddy Street, Providence, Rhode Island 02903 Work Type and Shift M‑F 8‑4:30, rotating weekends and holidays. Day shift. Driving Required No Union United Nurses And Allied Professional #J-18808-Ljbffr