RN-ED Case Manager

Eisenhower Health - Rancho Mirage, CA

Full-time - Entry Level

Rancho Mirage, CA

About the position

The RN-ED Case Manager is responsible for facilitating patient care from preadmission through discharge from the Emergency Department. This role involves collaboration with healthcare team members to ensure cost-effective and medically appropriate care, while also addressing the needs of patients across various age groups.

Responsibilities

• Facilitates patient hospitalization from preadmission through discharge.
• Interfaces with physicians, nurses, social workers, and other healthcare team members.
• Performs pre-admission and inpatient admission reviews to assure payment authorization.
• Acts as a resource regarding admission appropriateness and levels of care.
• Gathers information to facilitate appropriate discharge to the next level of care.
• Assists in triaging calls for patient transfers and determines transfer appropriateness.
• Escalates issues to physician advisors when necessary.
• Uses tracking systems to identify patients needing case management intervention.
• Coordinates patient transfer to appropriate levels of care.
• Identifies and resolves clinical and operational roadblocks to achieve optimal outcomes.
• Communicates decisions to patients, families, and healthcare team members.
• Collaborates with the interdisciplinary team to meet evidence-based standards of care.
• Identifies opportunities for care/service improvement.
• Assists in developing care performance improvement plans based on data analysis.
• Modifies the plan of care as patient needs change.
• Facilitates communication regarding the plan of care to all stakeholders.
• Initiates diagnostic services and treatment planning in the ED.
• Documents all care management assessments and interventions.
• Communicates with third-party payers regarding benefits and coverage.
• Maintains resources to meet patient needs and shares information with the team.
• Screens and refers patients for alternative care options when appropriate.
• Coordinates clinical and financial discharge planning needs.
• Refers complex psychosocial issues to Social Work for follow-up.
• Consults with interdisciplinary team members for safe discharge.

Requirements

• Valid RN License in California.
• BSN or MSN or enrollment in an RN-BSN or RN-MSN program within 1 year of hire.
• Minimum one year recent acute care hospital Case Management experience.
• Certification in Case Management preferred.

Nice-to-haves

• Experience in documentation review.

Benefits

• Flexible scheduling options for per diem shifts.
• Opportunity to work in a dynamic healthcare environment.