Registered Nurse Case Manager - Care Coordination - Edmonds
Company: Pacific Medical Centers
Location: Edmonds
Posted on: June 18, 2022
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Job Description:
Swedish Medical Center is looking for a RN Case Manager (0.9
FTE, Day Shift) to work for the Care Coordination Department at
Swedish Edmonds in Edmonds, WA. Free Parking, Full-Time benefits,
ORCA Pass commuter assistance and continuing education support are
just a few of our Caregiver Benefits!$10,000 Hiring Bonus for
eligible external candidates who meet all conditions for payment -
this is in addition to the fantastic benefits and compensation
package offered by Providence that begin on your first day of
employment.SCHEDULE: Monday - Friday; 8:00am-4:30pm PST. Weekend
component required as needed.The RN Case Manager is responsible for
clinical case management functions via a collaborative process that
transitions patients to optimal clinical outcomes while assuring
safe, cost-effective care. Demonstrates a daily commitment to the
department's value of this position you will: Clinical Essential
Functions: Performs new admission assessments within designated
time frames. Facilitates/supplements the staff nurse role in
reviewing, interpreting, integrating and analyzing patient clinical
findings. Communicates clinical findings and care recommendations
effectively and collaboratively to achieve targeted outcomes.
Ensures consistent standard of care including the physician
specific plan of care is followed for all patients. Assures
appropriate tests and treatments to the diagnosis are completed.
Ensures referrals for medical consults are completed in a timely
manner. Identifies "Captain of the Ship" in complex cases with
multiple practitioners. Intervenes clinically, as appropriate,
proposing alternatives to ensure a cost effective and efficient
plan of care that meets clinical and regulatory standards. Provides
supportive and therapeutic clinical interventions as indicated.
Evaluates and facilitates documentation Psychosocial Essential
Functions: Identifies risk factors and/or strengths of
patient/family support system on admission and refers/communicates
to appropriate team members. Identifies abuse/neglect and refers
appropriately for evaluation and reporting. Assures ethical
situations are identified and makes referrals to Medical Ethics
Committee as indicated. Ensures advance directives are in place and
honored according to the patient's wishes. Identifies primary
patient/family decision maker and communicates care plans as
indicated. Initiates and participates in patient/family conferences
as needed. Financial and Utilization Management Essential
Functions: Maintains knowledge of particular reimbursement methods
and communicates reimbursement information to patients, families
and the healthcare team. Ensures patients are placed in the
appropriate level of care according to the clinical situation and
prescribed plan of care. Screens for continued medical necessity
and level of care. Assures approved days from payers. Pre-screens
for financial issues surrounding admissions and transfers. Refers
patients to financial counselor for information and to implement
financial assistance forms. Maintains awareness of payer contract
requirements. Collaborates with managed care contracting staff on
elements of plan performance and contract requirements. Conducts
utilization review activities as required by managed care
contracts. Issues and explains extended stay denials. Reviews
impending denials with physician advisor. Assists with information
to support appeal of any business office denials. Researches
clinical denial claims and writes appeal letters. Documents
findings in patient medical record. Monitors avoidable delays and
days. Maintains awareness of interqual guidelines and DRG length of
stay standards.Required qualifications for this position include:
Nursing Baccalaureate degree (BSN) from an accredited school of
nursing required. Applicants without a BSN degree must actively
pursue and attain a BSN within five years of hire. Continued
employment by Swedish beyond five years is contingent upon
attaining the BSN degree. Registered Nurses employed by Swedish
prior to December 1, 2012 are encouraged to pursue the BSN degree,
but obtaining the degree will not be a condition of employment
Current Washington State Registered Nurse License Case Management
Certification required at hire or within 2 years of eligibility
Three (3) years current relevant clinical experiencePreferred
qualifications for this position include: Hospital-based case
management experienceAbout the Edmonds Campus:Swedish/Edmonds
(formerly Stevens Hospital) has been providing sound and thoughtful
care for patients in the greater Seattle area for more than 45
years. We pride ourselves in employing only the most qualified and
caring professionals. We are not simply a hospital or a workplace.
We are a family. We are a community. Our mission is to improve the
health and well-being of the community through local, high-quality
and compassionate health care services. On Sept. 1, 2010, Stevens
joined the Swedish family and became Swedish/Edmonds to create an
innovative, regional health-care delivery network that provides
more local services, while giving residents greater access to the
latest medical treatments and the comprehensive services of the
Swedish system.The Swedish/Edmonds campus includes: 217 licensed
beds 450 of the most qualified physicians and specialists on
medical staff 1,400 staff including clinical and non-clinical
personnel Full scope of medical and surgical services, including
Level IV Trauma emergency medicine, diagnostic, treatment and
support services
Keywords: Pacific Medical Centers, Edmonds , Registered Nurse Case Manager - Care Coordination - Edmonds, Executive , Edmonds, Washington
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