Registered Nurse/ Case Manager

<p>When you work with Henry Ford Health System, you&rsquo;re not just another employee, you&rsquo;re part of a community of experts dedicated not only to helping our patients, but also helping each other succeed. With ample opportunity, competitive benefits and a collaborative atmosphere, working at Henry Ford is not just another job, it&rsquo;s a way to do what you love and to be your best you!</p>

Detroit, MI

Henry Ford Health System

Founded in 1915 by auto pioneer Henry Ford, Henry Ford Health System (HFHS) is one of the nation&rsquo;s leading comprehensive, health systems. It provides health care delivery including acute, specialty, primary and preventive care services backed by excellence in research and education.<br /><br /> <ul> <li>Mission: To improve people's lives through excellence in the science and art of health care and healing.</li> <li>Vision: Transforming lives through health and wellness, one person at a time.</li> </ul> <br />Search for your next career with Henry Ford Health System &mdash; then apply, or recommend a friend. <a href="" target="_blank" rel="noopener noreferrer">CLICK HERE</a> to view all open careers.

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Competitive Compensation and Benefits Package

Overview: <p>This position focuses on clinical coordination of care and discharge planning. Utilization Review and coding is managed by a separate department.</p> <p>The purpose of the Case Manager I position is to support 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 payers. The role integrates and coordinates utilization management, patient education, care facilitation, and discharge planning functions.</p> <p>***This will be 8 hour day shifts with rotating weekends.***</p> <p>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 the Employee Assistance Program, Tuition Reimbursement, Paid Time off, Henry Ford Kids Child Care Center, Employee Health and Wellness and a whole host of other benefits and services.</p>
Responsibilities: <p>The Case Manager I is accountable for a designated patient caseload and plans effectively in order to meet patient needs, manage the length of stay, and promote efficient utilization of resources.&nbsp; Specific functions within this role include:</p> <ul> <li>Facilitation of precertification and payor authorization processes</li> <li>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</li> <li>Application of process improvement methodologies in evaluating outcomes of care</li> <li>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</li> <li>Coordinating communication with physicians.&nbsp;</li> <li>Ability to demonstrate knowledge and skills necessary to provide care appropriate to the patient served. Ability to demonstrate knowledge of the principles of growth and development as it relates to the different life cycles.</li> </ul> <strong>Principal Duties and Responsibilities</strong>: <ul> <li>Coordinates/facilitates patient care progression throughout the continuum.</li> <li>Works collaboratively and maintains active communication with physicians, nursing and other members of the multi-disciplinary care team to effect timely, appropriate patient management.</li> <li>Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate safe discharge.</li> <li>Performs specific competencies for population served.</li> <li>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&rsquo;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.</li> <li>Provides education to patient/family on disease management.</li> <li>Completes Utilization Management and Quality Screening for assigned patients.</li> <li>Applies approved clinical appropriateness criteria to monitor appropriateness of admissions and continued stays, and documents findings based on Department standards.</li> <li>Identifies at-risk populations using approved screening tool and follows established reporting procedures.</li> <li>Monitors length of stay and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas.&nbsp;&nbsp;</li> <li>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.</li> <li>Collaborates and communicates with multidisciplinary team in all phases of discharge planning&nbsp;&nbsp;&nbsp;&nbsp; process, including initial patient assessment, planning, implementation, interdisciplinary collaboration, teaching and ongoing evaluation.</li> <li>Meets directly with patient/family to assess needs and develop an individualized continuing care plan in collaboration with physician. &bull; Updates and maintains discharge plan of care with patient/family, physician and payor.</li> <li>Refers appropriate cases for social work intervention based on Department criteria.</li> <li>Collaborates/communicates with external case managers.</li> <li>Documents discharge planning information in the medical record according to Department standards.</li> <li>Facilitates transfer to other facilities as appropriate.</li> <li>Actively participates in clinical performance improvement activities.</li> <li>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.</li> <li>Uses data to drive decisions and plan/implement performance improvement strategies related to case management for assigned patients.</li> <li>Collects, analyzes and addresses variances from the plan of care/care path with physician and/or other members of the healthcare team.&nbsp; Uses concurrent variance data to drive practice changes and positively impact outcomes.</li> <li>Collects delay and other data for specific performance and/or outcome indicators as determined by Director of Case Management.</li> <li>Documents key clinical path variances and outcomes which relate to areas of direct responsibility (e.g., discharge planning).&nbsp; Uses pathway data in collaboration with other disciplines to ensure effective patient management concurrently.</li> <li>Ensures safe care to patients adhering to policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice.</li> <li>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.</li> </ul>
Requirements: <p><strong>Education/Experience Required: </strong></p> <ul> <li>Bachelors of Science in Nursing, required.</li> <li>Minimum of three years RN clinical experience, preferred.</li> <li>Possess interpersonal communication and negotiation skills.</li> <li>Possess analytical, data management and PC skills.</li> <li>Current working knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement, preferred.</li> <li>Organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components with minimal supervision.</li> <li>Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families.</li> <li>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.</li> </ul> <p><strong>Certifications/Licenses Required: </strong></p> <ul> <li>Current and valid license to practice as a Registered Nurse in the State of Michigan.</li> </ul>