Description
Job Description Summary:
The Care Manager/Discharge Planner (CM/DP) uses the nursing process to coordinate, negotiate, procure, and evaluate the care of patients to facilitate achievement of mutually defined patient outcomes. The CM/DP works collaboratively with interdisciplinary staff internal and external to the organization.
Education and Experience Requirements:
Requires: Two years' experience in acute or skilled nursing level of care; current Montana RN License; and current BLS Certification or ability to obtain within 2 months of hire.
Desires: Experience with care management process, including discharge planning, insurance reviews, hospice issues.
Position Responsibilities
I. The provision of CM/DP services to the patient's and families in the Logan Health - Whitefish community: The CM/DP assesses the needs of the patient population, plans for the realization of those needs, intervenes based on the assessment and planning process, and evaluates the outcomes. The CM/DP serves as a guide to patients and their families as they encounter information and decision-making events within the health care system. A. Identifies appropriate patients for care management and discharge planning based on patient needs and risk factors. B. Develops a network of the services and disciplines required by the patient receiving care management services. C. Establishes a system for coordinating patient care throughout the continuum of care, spanning each area in which care is provided. Assists patients and families in their decision-making. D. Establishes and maintains methods for tracking patient's progress through the health care systems. E. Maintains knowledge of the resources available in the community for patients/families. F. Demonstrates flexibility and creativity in identifying resources to meet patient/family needs. G. Introduces self to the patient/family, explains the CM/DP role, and enlists their cooperation in working with the CM/DP. H. Facilitates transfers within levels of care at LHW as well as transfers to receiving facilities. I. Collaborates closely with the LHW Hospitalist in discharge planning goals. J. Leads the multidisciplinary team in the daily patient report meeting.
II. Provides Utilization Review services to NV: Monitors resource consumption, census levels, and regulatory requirements for the patient population. Assists in the development of policies regarding regulatory compliance and health insurance mandates and implements those policies. A. Explores strategies to optimize resource consumption within the care managed patient populations, implements them and documents the results. Individualizes and guides care plans collaboratively with patients and families. B. The care manager participates in quality improvement and evaluation processes related to the management of patient care. C. Evaluates the outcomes of CM/DP on the targeted patient population collaboratively with other disciplines, patients and families. D. Maintains a knowledge of the requirements of the payers seen with the patient population, completes admission reviews and appeals, and executes contract requirements. E. Participates in the medical staff committee utilization review functions including education, evaluation, and policy formation. III. The CM/DP follows hospital and departmental policies and procedures: The CM/DP contributes to the efficiency of the operations of LHW. In particular, the CM/DP assists with the integration of clinical services by modeling the shared values and mission of LHW. A. Works as assigned. Demonstrates flexibility as it relates to scheduling availability. Arrives to work on time, having minimal absences or overtime. Promptly notifies Supervisor of illness or inability to work to enable adequate replacement. B. Confidentiality/Resident's Rights: Maintains confidential information regarding all residents, families, health care personnel, and the Logan Health - Whitefish community. C. Customer/Employee Relations: Serves as an ambassador of Logan Health - Whitefish. Supports staffing/scheduling policies to meet client needs. Promotes unit/department philosophy and goals. Treats others with respect and dignity, recognizing individual uniqueness of clients and colleagues. Demonstrates honest and open review of peers with an effort to influence change positively. Complies with the standards, policies and procedures of Logan Health - Whitefish. Promotes efficient and effective resource utilization. D. Safety/Infection Control: Demonstrates safe work habits, utilizing proper body mechanics and infection control policies and procedures. Demonstrates awareness of appropriate emergency procedures. E. Continuing Education: Attends all mandatory hospital in-service programs and departmental meetings. Complies with department education requirements.
F. Appearance: Demonstrates a professional image through appropriate dress and appearance. G. Professional Development: Demonstrates interest and initiative in professional development. Demonstrates and reinforces professional behaviors in self and colleagues. Fosters developmental and educational process of orientees, students and colleagues. H. The CM/DP is a social service designee for the LHW swing bed program. I. Participates on hospital committees and special projects as assigned. J. Complies with CAH regulations, policies, and procedures.
IV. Manages opportunities for performance improvement. A. Identifies opportunities for quality improvement. B. Works with others to develop a plan of action. C. Implements changes and monitors results by submitting timely reports to the performance improvement committee.
V. Other duties as assigned.
VI. Compliance Plan and Code of Conduct: LHW is dedicated to the highest ethical standards as it is essential to meeting our commitment to our mission and vision. Individual responsibilities include adhering to our organizational Compliance Plan and Code of Conduct. A. Maintains awareness and understands the organization-wide compliance plan. Familiar with and adheres to LHW's published Code of Conduct which provides guidance and expectations regarding confidentiality, conflict of interest, billing, controlled substances, Emergency Medical Treatment and Labor Act (EMTALA), payments for referrals, gifts, anti-kickback laws, safety and health, waste disposal, and compliance with antitrust laws, advertising and marketing, discrimination, insider trading and government requests. B. Reports any violation or suspected violation of this Code or other hospital policies or procedures to supervisor, Compliance Officer or through the compliance hotline. C. Attends and/or completes mandatory training regarding organizational compliance.
Shift:
Day Shift - 8 Hours (United States of America)
Schedule Details:
Please know schedules and shifts are subject to change based on patient care and department/organization
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