Description
At NorthBay Health the Emergency Department Case Manager (EDCM) is to assess, plan, implement, monitor and evaluate options and services to affect an appropriate, individualized plan for patient care in the Emergency Department (ED) and extending across the continuum of care. The EDCM ensure patients are transitioned to optimal level of care as quickly as possible.
The EDCM make recommendations to the Interdisciplinary Care Team on continued patient needs from a utilization and case management perspective and effectively communicates and collaborates with the patient, family, physician(s), nursing, and other health care team members to coordinate post ED care. Using independent judgment and discretion, the patient must be assessed and reassessed as an ongoing process to address the patient's broad spectrum of needs through the ED episode.
The EDCM utilize clinical knowledge and competence, positive communication skills, problem solving and conflict resolution techniques, ability to effect change, strong skills in assessment, organization, and time management. The case management process requires a focus on critical thinking skills, customer service skills, setting appropriate goals and measuring outcomes to effectively ensure optimal patient outcomes with consideration to financial and healthplan resources.
The EDCM communicate appropriate information to care providers in the continuum of care, monitors/reports ED utilization trends and intervenes as appropriate to ensure patients are connected with available resources. Documents assessment and interventions in Cerner. Collaborates with the Patient Placement Coordinators/Administrative Coordinators in verifying medical necessity and insurance contract compatibility prior to a bed assignment for admitted patients from the ED. Uses MCG criteria to assess appropriate level of care and medical necessity for admission/observation status. Assesses patients based on age and development stage utilizing resources needed for both care and financing.
The EDCM will coordinate transfers into the appropriate facility at the correct level of care ensuring that continued hospitalization is warranted, contracted, and appropriate. The EDCM at NorthBay Healthcare must be able to demonstrate and be accountable for the policies, procedures, quality assurance, guidelines and goals of the department and the organization. The EDCM will provide assistance to coworkers in the inpatient setting as able and/or as directed by the Supervisor, or designee. The EDCM work under the direction of Inpatient Case Management Supervisor or designee.
Qualifications
JOB SPECIFICATIONS
- Education and: Graduate of an accredited nursing school or college. BSN required, unless in grandfathered status, MSN preferred.
- Licensure: Current California state RN license. Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred.
- Experience: Minimum of 3 years acute clinical nursing experience required. ED Experience preferred. Minimum 2 years Case Management experience preferred
- Skills: Basic knowledge of personal computer and software for word processing and good keyboard skills required. Ability to enter and retrieve data from relevant computer systems required. Must be competent in Microsoft Office programs including Outlook and Word. Experience with MCG, Cerner, and Power Point preferred. Knowledge of Medicare rules and regulations and Conditions of Participation, Joint Commission, Patient Safety, and the Department of Health organizational standards. Knowledge of acute care, home care, subacute care, long-term care, hospice interventions, rehabilitation options, other community resources and requirements, medical necessity guidelines, quality assurance process and determination of positive outcomes, current standards and trends in health care, best practices, management tools, and familiarity with related resources and literature.
- Compensation $80.73- $97.33
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