POSITION SUMMARY: Position is filled by a professional nurse who, as a result of education and in-depth clinical experience possesses the advanced clinical knowledge and skills necessary to provide case management to targeted populations. Responsible for coordinating and facilitating the patient's hospitalization from pre-admission through post-discharge. Collaborates with physicians, nurses, social workers and other health team members to expedite medically appropriate cost effective care. Applies clinical expertise and medical appropriateness criteria to resource utilization and discharge planning achieve desired health maintenance and disease prevention outcomes. Will advise the health care team and provide leadership as necessary. Communicates at the inter-departmental level as well as across all health care areas with the goal of improving clinical management of patients thereby impacting medical and psychosocial care across the health care continuum. Core processes include risk assessment and management of clinical populations, discharge planning, and utilization management.
POSITION DUTIES: Level 1 Skilled
1.1 Using established criteria, reviews appropriateness of patient's admission, need for continued stay, information needed for discharge.
1.2 Discuss estimated length of stay, treatment and discharge plan with the attending physician, as indicated
1.3 Initiate discharge planning by assessing the patient's needs and documenting the assessment on the interdisciplinary plan of care. Interviews patient, family, and appropriate health team members to develop a discharge plan that incorporates patient choice, and is clinically appropriate, cost effective, and safe.
1.4 Ensure that the interdisciplinary care plan and the discharge plan are consistent with the patient's clinical course, continuing care needs and covered services.
1.5 Refers complex discharge planning issues to other members of the case management team as directed by referral criteria.
1.6 Provides leadership to the health care team to implement the discharge plan and facilitate patient transfer to the next level of care when medically able.
1.7 Obtain from third party payer certification due to patient status change, information needed for discharge.
.8 Conducts interdisciplinary rounds
1.9 Discuss with attending physician and/or physician advisor the appropriateness of resource utilization, consultation and treatment plan.
1.10 Collect data on variances from quality screening criteria by the Clinical Excellence Council. Report quality concerns to Quality Assurance. Continually ensure and enhance quality outcomes
1.11 Respond to third party requests for concurrent clinical information.
1.12 Complete all necessary forms in a timely manner.
1.13 Act as a liaison/patient advocate and influence interactions to ensure high quality patient care.
1.14 Coordinate appropriate educational material/instruction for patients, families, medical staff, and multi-disciplinary personnel to accomplish patient care outcomes. 1.15 Maintain cost effective utilization of care continuum resources.
1.16 Coordinate with all staff necessary to develop a mechanism to monitor patient progress against guidelines and evaluate variances for individual patients and targeted populations.
1.17 Identify possible delays and avoidable days; work with providers to prevent delays and identify system/provider opportunities for improvement.
Skills Required: Ability to asses care needs across populations and plan for care-including transitional care and discharge; leadership; demonstrated ability to communicate with physicians, nurses, other clinicians, and public; teaching; organizational skills; team building and collaboration; psychosocial assessment; interview; documentation; identification of potential risk situations or potential liability; Coordination of development, implementation and evaluation of clinical paths; comprehensive assessment for designated level of care; identification and documentation of Quality Management adverse events and outcomes.
Education Required: Associates degree in nursing or related field or equivalent combination of work experience and education
Preferred: Bachelorï¿½s degree in Nursing Licensure Required: RN License in the state of Arizona Certificates
Preferred: Certification in specialty area, and/or Case Management Experience
Required: Recent Acute care experience
Preferred: Combined bedside and care management experience
Knowledge Required: Quality improvement process, related health care practices and standards; knowledge and competency in providing care for patients in designated age groups competencies; current practices, issues, regulations involved in transitions and discharge planning; psychosocial aspects of disease and health care; professional and regulatory standards Current practices, issues, regulations involved in utilization management; risk assessment and management of clinical populations.
Technology Required: Basic computer skills, personal technology tools, and awareness of current use of technology in related field.
Preferred: Advanced computer skills, technology of the specialty
Other Required: Must be able to transport self within the service area as required. When using own vehicle must have valid Arizona driverï¿½s license and proof of insurance that meets the minimum standards of the state of Arizona. Must be able to take call duty, weekend, holiday and evening/night shift as required.
Job: Case Management/Home Health
Primary Location: Tucson, Arizona
Facility: Carondelet St. Mary's Hospital
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 1905020728
About Carondelet St. Mary's Hospital
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.