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Find our Physician, Nurse Practitioner, Physician Assistant, Medical Director and other advanced practice openings on psdconnect.org.
Find our Physician, Nurse Practitioner, Physician Assistant, Medical Director and other advanced practice openings on psdconnect.org.
Description:
Providence is calling a Admissions Nurse Case Manager (RN) (Utilization Review,Day-shift, 1.0 FTE) to St. Patrick Hospital in Missoula, Montana. We are a community of caregivers delivering every day on our Mission to provide compassionate care that is accessible for all – especially those who are poor and vulnerable.
Apply Today! Applicants that meet qualifications will receive a text with some additional questions from our Modern system.
In this position you will:
Responsible to assess all ED and other unplanned patient admissions during work hours
Assessment parameters to include identifying medical necessity criteria, corresponding correct registration status, and discussing findings with admitting provider when indicated by review
Review all status orders for patients to a bed from procedural areas including, but not limited to, Surgery, CVL, Endoscopy and Radiology to verify correct status order and related medical necessity as appropriate
Under the direction of the department Manager, is also responsible for directing an organized, patient-centered interdisciplinary team system that coordinates the delivery of healthcare services by continually monitoring, evaluating, and modifying the treatment plan to achieve optimal patient outcomes and efficacious use of resources
Coordinate with physicians, other Nurse Case Managers Social Worker, and other health team members to expedite medically appropriate, cost-effective care and promote quality through evidence based medical practice throughout the health care system
Address variance findings through research, planning and system improvement using IDT approach incorporating LEAN methodologies
Continuously assess, develop, and implement discharge patient/family needs and work with appropriate healthcare provider to procure necessary services
Coordinate finalization of all discharge related recommendations when appropriate
Demonstrate caring and involved behaviors to patient/family members and play an advocacy role to ensure positive outcomes
Develop and direct continuum of care map in collaboration with interdisciplinary team
Document avoidable days/delays with attributions as identified when appropriate
Effectively communicates and involves patient/family in discharge planning. when appropriate
Facilitate case finding to refer conversation regarding end-of-life decision making and attempt to reduce the frequency of artificially prolonged and painful dying by eliciting preferences, improving understanding of outcomes, encouraging attention to pain control, advance care planning, and patient-physician communication
Facilitate maximum access to benefits to meet discharge need when appropriate
Identify internal and/or external resources and refers appropriately to meet patient needs when appropriate
Identify possible situations of abuse, neglect or exploitation utilizing knowledge of physical and psychosocial indicators of abuse
Make referral calls to appropriate agencies
If case is not encountered, then must attend at least one educational session on this topic, and provide documentation of attendance
Identify obstacles to efficiency and goal outcomes and intervene to overcome or eliminate these when possible as documented by Avoidable/Unavoidable Days reported
Identify, monitor and collaborate with IDT for timely completion of patient education when appropriate
Maintain clinical competency and current knowledge of financial, regulatory, and payer requirements to perform job responsibilities
Maintain the security and confidentiality of data and information used in the performance of his/her daily duties conforming to hospital policy, laws and regulations as appropriate
Negotiate with healthcare agencies for services as needed
Participate in identified LEAN/change activities
Participate in UM/UR data collection in relation to topics identified by Utilization Management Committee
Provide completed tracking tools as specified for aggregation and department report to as requested
Possess knowledge of institution/payer policies, procedures and the law and uses that knowledge appropriately
Promote optimal allocation of healthcare services through effective and efficient use of resources across continuum of care
Provide education regarding healthcare and social resource systems to empower patient/family to access resources independently
Serve as a resource to healthcare team throughout healthcare system in promoting clinical guidelines
Use and document level of care criteria and length of stay /anticipated day of discharge expectations for all patients assessed and being placed within the hospital
Use and document level of care criteria for all patients within their assignment and documents status recommendation and outcome within EPIC
Qualifications:
Required qualifications for this position includes:
Graduate of an accredited school of nursing or Graduate of an accredited health information technology program
Current licensure in the State of Montana as a Registered Nurse
Three (3) years current clinical hospital experience, or Nursing Management experience, or previous experience as a Case Manager
Preferred qualifications for this position include:
About the hospital you will serve.
St. Patrick Hospital in Missoula, Montana has more than 250 licensed beds and serves patients from 17 counties. We have been recognized as a Thomson Reuters Top 100 Hospital and among many other awards, have earned the Premier Award for Quality award repeatedly. Missoula is halfway between Yellowstone and Glacier National Park. It is a university city of 65,000, surrounded by big sky, scenic mountains, forests and renowned rivers.
We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit
https://www.providenceiscalling.jobs/rewards-benefits/
Our Mission
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
About Us
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Schedule: Full-time
Shift: Day
Job Category: Case Management
Location: Montana-Missoula
Req ID: 348664