Henry Ford Health System RN Inpatient Case Manager I / Henry Ford Hospital / 40 hours Day shift in Detroit, Michigan
A new opportunity is available for an Inpatient Case Manager at the Henry Ford Hospital in midtown Detroit.This position works with a designated inpatient unit within the hospital.A BSN degree is required for this position.• Position: Full time 40 hours per week• Shift: 8 hour day shift / occasional weekend & holiday rotations• Benefits: Full time benefit packageMinimum pay rate is $28.69. Previous nursing experience, case management and utilization management experience is factored in for final salary offer.GENERAL OVERVIEW:The Case Manager I position supports the physician and interdisciplinary team in facilitating patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payors. The role integrates and coordinates utilization management, patient education, care facilitation, and discharge planning functions.The Case Manager I is accountable for a designated patient caseload on a specific unit and plans effectively in order to meet patient needs, manage the length of stay, and promote efficient utilization of resources. Specific functions within this role include:• Facilitation of precertification and payor authorization processes.• Facilitation of the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement.• Application of process improvement methodologies in evaluating outcomes of care.• Support and coaching of clinical documentation efforts and serving as a clinical resource for coders ensuring that documentation accurately reflects severity of illness and intensity of service.• Coordinating communication with physicians. Entire Job Description Responsibilities 1. Coordinates/facilitates patient care progression throughout the continuum. Works collaboratively and maintains active communication with physicians, nursing and other members of the multi-disciplinary care team to effect timely, appropriate patient management. Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate safe discharge. Performs specific competencies for population served. Proactively identifies and resolves delays and obstacle to discharge. Collaborates with the physician and all members of the multidisciplinary team to facilitate care for designated case load; monitors the patient’s progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient, on a timely basis and cost effective. Provides education to patient/family on disease management. 2. Completes Utilization Management and Quality Screening for assigned patients. Applies approved clinical appropriateness criteria to monitor appropriateness of admissions and continued stays, and documents findings based on Department standards. Identifies at-risk populations using approved screening tool and follows established reporting procedures. Monitors length of stay and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas. 3. Ensures that all elements critical to the plan of care have been communicated to the patient/family and members of the healthcare team and are documented as necessary to assure continuity of care. 4. Collaborates and communicates with multidisciplinary team in all phases of discharge planning process, including initial patient assessment, planning, implementation, interdisciplinary collaboration, teaching and ongoing evaluation. Meets directly with patient/family to assess needs and develop an individualized continuing care plan in collaboration with physician. Updates and maintains discharge plan of care with patient/family, physician and payor. Refers appropriate cases for social work intervention based on Department criteria. Collaborates/communicates with external case managers. Documents discharge planning information in the medical record according to Department standards. Facilitates transfer to other facilities as appropriate. 6. Actively participates in clinical performance improvement activities. Assists in the collection and reporting of resource and financial indicators including case mix, length of stay, cost per case, excess days, resource utilization, readmission rates, denials and appeals. Uses data to drive decisions and plan/implement performance improvement strategies related to case management for assigned patients. Collects, analyzes and addresses variances from the plan of care/care path with physician and/or other members of the healthcare team. Uses concurrent variance data to drive practice changes and positively impact outcomes. Collects delay and other data for specific performance and/or outcome indicators as determined by Director of Case Management. Documents key clinical path variances and outcomes which relate to areas of direct responsibility (e.g., discharge planning). Uses pathway data in collaboration with other disciplines to ensure effective patient management concurrently.7. Ensures safe care to patients adhering to policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice.8. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization.
EDUCATION/EXPERIENCE:• Bachelors of Science in Nursing is required.• Minimum of 3 years inpatient RN experience is preferred.• Possess interpersonal communication and negotiation skills.• Possess analytical, data management and PC skills.• Current working knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement, preferred.• Organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components with minimal supervision.• Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families.• Performs duties in a manner to promote quality patient care and customer satisfaction, while promoting safety, cost efficiency, and a commitment to Continuous Quality Improvement process.Overview Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health care systems, is a national leader in clinical care, research and education. The system includes the 1,200-member Henry Ford Medical Group, five hospitals, Health Alliance Plan (a health insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory network and many other health-related entities throughout southeast Michigan, providing a full continuum of care. In 2015, Henry Ford provided $299 million in uncompensated care. The health system also is a major economic driver in Michigan and employs more than 24,600 employees. Henry Ford is a 2011Malcolm Baldrige National Quality Award recipient. The health system is led by President and CEO Wright Lassiter III. To learn more, visitHenryFord.com. Benefits Whether it's offering a new medical option, helping you make healthier lifestyle choices or making the employee enrollment selection experience easier, it's all about choice. Henry Ford Health System has a new approach for its employee benefits program - My Choice Rewards. My Choice Rewards is a program as diverse as the people it serves. There are dozens of options for all of our employees including compensation, benefits, work/life balance and learning - options that enhance your career and add value to your personal life. As an employee you are provided access to Retirement Programs, an Employee Assistance Program (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other benefits and services. Equal Employment Opportunity/Affirmative Action Employer Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.