Cleveland Clinic RN-Case-Manager in Avon, Ohio

Job Summary:

Facilitates effective and efficient delivery of in hospital care. Integrates and coordinates care facilitation and discharge planning in partnership with the physician and nursing staff and the entire interdisciplinary team. Serves as a liaison between the patient/family, physician, and payer through this portion of the continuum of care. Ensures compliance with CMS Conditions of Participation, standards of the accrediting bodies and the state mandated revised code.

Responsibilities:

  • Coordinates and facilitates patient care progression throughout the continuum.

  • Collaborates with Social work on the facilitation of transfers internally to SNF, ARF, LTACH, Home Care.

  • Works collaboratively with physicians, nursing, and other members of the multidisciplinary team to maintain active communication in order provide effect timely, appropriate patient management.

  • Proactively identifies and, in partnership with the care team, resolves delays and barriers to discharge.

  • Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting.

  • Participates in patient rounding activities such as daily caseload rounding to establish priorities for self, SW and high risk TCC, multidisciplinary care coordination/discharge planning rounds, hand off report to nursing staff, hand off report to post-acute facilities SCC and PCC, physician advisor rounds and weekly LOS rounds.

  • Participates in various committee meetings as assigned.

  • Addresses and resolves items impeding diagnostic or treatment progress. Participates in Data Collection and inputting (e.g., Avoidable Days, Readmissions, Important Message letter delivery, Condition Code 44, etc.).

  • Ensures compliance with CMS Conditions of Participation, standards of the accrediting bodies and the state mandated revised code. Other duties as assigned.

Education:

  • Graduate of an Accredited School of Nursing;

  • Bachelor of Science in Nursing required within 5 years of start date after 4/1/14 for all external hires and voluntary internal transfers.

Certifications:

  • Current State Licensed Registered Nurse (RN).

  • Certification in Care Management (CCM) required within one year of eligibility.

  • Basic Cardiac Life Support (BLS) required.

Complexity of Work:

  • Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.

  • Must be able to work in a stressful environment and take appropriate action.

Work Experience:

  • Minimum of three years of clinical nursing experience required.

  • Minimum of two years of experience in Utilization Review, Quality, or Care Management preferred.

  • Knowledge of acute care regulatory/accreditation requirements preferred.

  • Discharge planning and/or Quality Improvement experience preferred.

Physical Requirements:

  • Requires full range of motion, manual and finger dexterity and eye-hand coordination.

  • Requires standing and walking for extensive periods of time.

  • Requires normal or corrected hearing and vision to normal range.

  • Sedentary work exerting up to 10 pounds of force occasionally (Occasionally: active or condition exists up to 1/3 of the time) and /or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

Personal Protective Equipment:

  • Follows Standard Precautions using personal protective equipment as required for procedures.