Inpatient Care Manager
Company: Aurora Health Care
Location: Downers Grove
Posted on: August 4, 2022
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Job Description:
Major Responsibilities:Assists in the development,
implementation, and evaluation of a multidisciplinary,
individualized patient plan of care that includes an appropriate
transition plan 6)Works collaboratively with the care management
team on complex cases to ensure that identifiable needs are
addressed prior to transition from the hospital setting. 7)Assesses
risk of readmission for specified patient populations and initiates
assigned interventions that will enhance the patient's ability to
successfully transition along the care continuum 8)Serves as a
resource for alternate venues of care delivery, and works
proactively to prevent duplication, fragmentation, and use of
unnecessary resources. 9)Serves as a resource for the initiation,
development, and implementation of pathways, algorithms, standards
and guidelines to guide the progression of care 1)Performs rounds
on assigned patients to coordinate care through assessing needs,
communicating, evaluating, and making recommendations to the plan
of care, as needed. 2)Evaluates the plan of care for individual
patients and/or patient populations, utilizing nationally
recognized medical necessity criteria, to assure that care is based
on accepted standards, evidence based practice, and current
research. 3)Acts as a liaison by collaborating and communicating
with the physician, patient, family, and other members of the
healthcare team. 4)Identifies the need for, arranges, and
participates in family care conferences, as needed. 5)Initiates
referrals to other internal and external healthcare providers,
after collaboration with the physician, to assure timely
progression and continuity of care, i.e. physical therapy,
outpatient ECM, home care, palliative care, hospice,
etc.Communicates with physicians, patients, families, and other
members of the healthcare team to coordinate transition planning.
1)Assesses the needs of assigned patients for transition planning.
Works collaboratively with the social worker and other disciplines
to ensure a safe, appropriate, and timely transition to the next
level of care, taking into consideration the patient's available
resources. 2)Identifies barriers early in the patient's stay,
formulating a plan with the patient, family, internal and external
members of the healthcare team, payers, and community resources.
3)Makes appropriate referrals to social services, ancillary
departments, enterprise case management, and other outside agencies
4)Communicates transition plans with other members of the
healthcare teamWorks with physicians and other members of the
healthcare team to ensure efficient utilization of
multidisciplinary resources 1)Works closely with the physician and
nursing team to ensure that all activities related to the plan of
care are completed in a timely manner. 2)Evaluates scheduling of
patient's procedures to provide timely customer focused services,
proactively intervening to expedite testing, as needed.
3)Identifies and communicates with the physician, opportunities for
tests, procedures, and therapies to be completed on an outpatient
basis. 4)Interacts with internal and external members of the
healthcare team to assure appropriate utilization of resources and
efficient movement of the patient through the care
continuum.Identifies variances from established utilization
management criteria, plans of care, pathways, algorithms, and
guidelines and facilitates the development of action plans.
1)Utilizes the designated medical necessity screening criteria to
identify, document and communicate the appropriate level of care,
continued stay, and length of stay variances. 2)Collects avoidable
day data and other pertinent information for data analysis
3)Identifies and reports significant variances and/or service
delays from established plans of care, inappropriate level of care,
and complex case concerns to the Medical Director/Physician Advisor
of care management. 4)Actively participates in clinical case review
with the Medical Director/Physician Advisor and other leaders of
the care management department. 5)Reports data and elevates
barriers to appropriate leadership for information and resolution,
which may include, but not limited to risk management, infection
control/prevention, and performance improvement. 6)Promotes patient
safety by reporting of issues through established channels and
participating, as requested in safety initiatives. 7)Represents the
care management department on various teams and performance
improvement activities addressing opportunities to improve clinical
progression and coordination of care and strengthen evidence-based
practiceResponsible for Professional Growth 1)Maintains knowledge
of current standards of care via literature review and
participation in educational offerings. 2)Completes required
contact hours based on licensure and certification.Licensure:Nurse,
Registered (RN)Education/Experience Required:New Hires/transfers:
BSN required as of 1/1/2016. Prior to 1/1/2016: must be enrolled in
BSN program by 11/4/16, must be complete by 1/1/20 3-4 years'
recent experience in care management or 5 years relevant clinical
experience.Knowledge, Skills & Abilities Required:Effective
interpersonal communication skills- verbal and written. ---Ability
to work with diverse teams and individuals, team player ---Ability
to prioritize work ---Utilization of critical thinking in timely
decision-making ---Basic computer skillsCurrent RN license in the
State of IllinoisPhysical Requirements and Working
Conditions:Embraces changing paradigm for enterprise care
management and the need to act in a more coordinated and integrated
fashion across the enterprise ---Willing to be accountable for KRAs
related to managing LOS, resource utilization (cost), readmissions.
---Ability to work in a fast paced environment with established
time constraints and in difficult situations ---Flexible hours
according to customer needs ---Ability to prioritize independently
and respond to multiple simultaneous requests ---Ability to
recognize needs and behaviors of specific age groups of assigned
patients ---Ability to lift weight up to 20 pounds ---May be
exposed to hazardous material and life-threatening diseasesIf
position has direct patient care or direct patient contact the
following lifting requirement supersedes any previous lifting
requirement effective 06/01/2015. Ability to lift up to 35 pounds
without assistance. For patient lifts of over 35 pounds, or when
patient is unable to assist with the lift, patient handling
equipment is expected to be used, with at least one other
associate, when available. Unique patient lifting/movement
situations will be assessed on a case-by-case basis.This job
description indicates the general nature and level of work expected
of the incumbent. It is not designed to cover or contain a
comprehensive listing of activities, duties or responsibilities
required of the incumbent. Incumbent may be required to perform
other related duties.
Keywords: Aurora Health Care, Downers Grove , Inpatient Care Manager, Executive , Downers Grove, Illinois
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