Inpatient Nurse Care Manager

Department :

11220 Advocate Sherman Hospital - Quality Management

Status : Full time

Benefits Eligible : Yes

Hou rs Per Week : 40

Schedule Details / Additional Information :

0800-1630 M-F weekend and holiday rotation

Pay Range

$37.50 - $56.25

Inpatient Care Manager

Sherman Hospital

M-F 8am to 4 : 30 Weekend and Holiday Rotation

The Care Manager (CM) is accountable for proactive coordination and timely transition of assigned patients to the most appropriate level of care along the continuum. This position will impact key results such as achieving top decile performance in length of stay, cost efficient resource utilization, preventing readmissions and unnecessary emergency room visits. The CM will work collaboratively with Physicians, Nursing, members of the multidisciplinary team, Outpatient Enterprise Care Management, Home Care and PCP offices as well as other resources external to the organization

Major Responsibilities :

​Assists in the development, implementation, and evaluation of a multidisciplinary, individualized patient plan of care that includes an appropriate transition plan

o 1)Performs rounds on assigned patients to coordinate care through assessing needs, communicating, evaluating, and making recommendations to the plan of care, as needed.

o 2)Evaluates the plan of care for individual patients and / or patient populations, utilizing nationally recognized medical necessity criteria, to assure that care is based on accepted standards, evidence based practice, and current research.

o 3)Acts as a liaison by collaborating and communicating with the physician, patient, family, and other members of the healthcare team.

o 4)Identifies the need for, arranges, and participates in family care conferences, as needed.

o 5)Initiates referrals to other internal and external healthcare providers, after collaboration with the physician, to assure timely progression and continuity of care, i.e. physical therapy, outpatient ECM, home care, palliative care, hospice, etc.

o 6)Works collaboratively with the care management team on complex cases to ensure that identifiable needs are addressed prior to transition from the hospital setting.

o 7)Assesses risk of readmission for specified patient populations and initiates assigned interventions that will enhance the patient’s ability to successfully transition along the care continuum

o 8)Serves as a resource for alternate venues of care delivery, and works proactively to prevent duplication, fragmentation, and use of unnecessary resources.

o 9)Serves as a resource for the initiation, development, and implementation of pathways, algorithms, standards and guidelines to guide the progression of care.

Communicates with physicians, patients, families, and other members of the healthcare team to coordinate transition planning.

1)Assesses the needs of assigned patients for transition planning. Works collaboratively with the social worker and other disciplines to ensure a safe, appropriate, and timely transition to the next level of care, taking into consideration the patient’s available resources.

o 2)Identifies barriers early in the patient’s stay, formulating a plan with the patient, family, internal and external members of the healthcare team, payers, and community resources.

o 3)Makes appropriate referrals to social services, ancillary departments, enterprise case management, and other outside agencies

o 4)Communicates transition plans with other members of the healthcare team.

Works with physicians and other members of the healthcare team to ensure efficient utilization of multidisciplinary resources

o 1)Works closely with the physician and nursing team to ensure that all activities related to the plan of care are completed in a timely manner.

o 2)Evaluates scheduling of patient’s procedures to provide timely customer focused services, proactively intervening to expedite testing, as needed.

o 3)Identifies and communicates with the physician, opportunities for tests, procedures, and therapies to be completed on an outpatient basis.

o 4)Interacts with internal and external members of the healthcare team to assure appropriate utilization of resources and efficient movement of the patient through the care continuum.

Identifies variances from established utilization management criteria, plans of care, pathways, algorithms, and guidelines and facilitates the development of action plans.

o 1)Utilizes the designated medical necessity screening criteria to identify, document and communicate the appropriate level of care, continued stay, and length of stay variances.

o 2)Collects avoidable day data and other pertinent information for data analysis

o 3)Identifies and reports significant variances and / or service delays from established plans of care, inappropriate level of care, and complex case concerns to the Medical Director / Physician Advisor of care management.

o 4)Actively participates in clinical case review with the Medical Director / Physician Advisor and other leaders of the care management department.

o 5)Reports data and elevates barriers to appropriate leadership for information and resolution, which may include, but not limited to risk management, infection control / prevention, and performance improvement.

o 6)Promotes patient safety by reporting of issues through established channels and participating, as requested in safety initiatives.

o 7)Represents the care management department on various teams and performance improvement activities addressing opportunities to improve clinical progression and coordination of care and strengthen evidence-based practice.

Responsible for Professional Growth

o 1)Maintains knowledge of current standards of care via literature review and participation in educational offerings.

o 2)Completes required contact hours based on licensure and certification.

Licensure :

• Nurse, Registered (RN)

Education / Experience Required :

Knowledge, Skills & Abilities Required :

Physical Requirements and Working Conditions :

Our Commitment to You :

Advocate Health offers a comprehensive suite of Total Rewards : benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including :

Compensation

Benefits and more

About Advocate Health

is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names in Illinois; in the Carolinas, Georgia and Alabama; and in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.