Registered Nurse Case Manager – Hospice
Mission Healthcare
RN Case Manager
ConcertoCare
full-time
Posted on:
Origin: • 🇺🇸 United States • Rhode Island, Washington
Visit company websiteSalary
💰 $90,000 - $100,000 per year
Job Level
Mid-LevelSenior
About the role
- Conduct initial intake calls as well as scheduled and urgent patient outreach based on individual patient’s needs and risk level to review and update the care plan, monitor progress, ensure needs are met, and identify new areas of concern.
- Provide ongoing care coordination for an assigned panel of complex patients.
- Conduct needs assessments and develop plans of care in partnership with the rest of the patient’s care team.
- Ensure care is coordinated, patient-centered, and aligned with the needs and wishes of the patient.
- Support patients during care transitions, including outreach and assessment during and post hospitalization to ensure discharge needs are addressed, to facilitate provider follow-up, and to perform medication reconciliation.
- Identify and implement interventions and collaborate closely with ConcertoCare’s multidisciplinary team (providers, Director of Clinical Care, market nurses, social work, behavioral health, and clinical pharmacy), external providers, and social service organizations to: (1) address gaps in care, (2) mitigate the risk of inpatient admissions, readmissions, emergency room visits and movement to an institutional setting, (3) and keep patients safely living in their desired and appropriate home environment.
- Identify and verify appropriate utilization of resources across the continuum of care.
- Actively participate in interdisciplinary care team huddles, and other clinical meetings.
- Participate in quality improvement and evaluation processes.
- Adhere to compliance policies, procedures, and standards of conduct including all applicable laws and regulations.
- Other duties as assigned.
Requirements
- Current RN License in good standing in the state of Rhode Island required or unencumbered multistate RN license.
- Reside in Rhode Island or within a commutable distance.
- Minimum associate degree in nursing required, bachelor's degree preferred
- Minimum of 3 years’ experience working in a clinical setting, with at least one year of case management experience in home health care, ambulatory care, community public health, and/or the insurance setting.
- Certified Case Manager (CCM) certification or commitment to complete when eligible
- Geriatric care experience highly desired
- 1 year discharge planning, utilization management, case management, performance improvement, and/or managed care preferred.
- Knowledge of Medicare and Medicaid regulations and insurance benefits preferred
- Strong clinical skills and ability to implement evidenced-based care.
- Ability to manage patient complexity and multiple clients with diverse needs
- Demonstrated ability to triage patient reported symptoms and issues that require escalation to our field-based team and apply critical thinking skills in unexpected circumstances.
- Ability to communicate effectively in writing and verbally.
- Demonstrated ability to perform multiple concurrent tasks with minimal supervision and meet deadlines.
- Ability to work in a fast paced, dynamic environment and work well with others on a team.
- Proficient computer skills including Microsoft Office Suite (Outlook, Excel, PowerPoint, Word) as well as clinical systems/ EMR competency
- Knowledge and ability to navigate internet-based tools and applications, and proficient in computer documentation
- Demonstrates a high level of professionalism.
