Clinical Resource Manager PRN

About the role

Employment Type: Part time

Shift: Rotating Shift

About the role

• CLINICAL RESOURCE MANAGER
• NAMPA MEDICAL CENTER
• PRN

General Summary and Purpose

Provides hospital case management and discharge planning collaboratively determining level of care needs beyond acute care, providing decision support to patients/families and physicians, managing patient and family expectations, and ensuring a smooth transition to the next level of care and services. Coordinates the integration of social services into patient care as appropriate/available.

Coordinates the hospital activities concerned with case management and discharge planning. Adheres to departmental goals, objectives, standards of practice, and policies and procedures. Ensures quality patient care and adheres to regulatory compliance. Provides concurrent assistance and support to physicians and other clinical members of the health care team in coordinating the delivery of services for a select group of patients.

To help achieve quality clinical and cost outcomes, the clinical resource manager incorporates real-time contacts with physicians, nursing, and ancillary care givers to establish specific treatment, cost, and transition targets and to facilitate transition planning.

Skills, Knowledge, Education and Experience

• Colleague must have an RN license, as defined by their primary work state (Idaho or Oregon), issued prior to hire date.
• Bachelor's Degree in Nursing or related healthcare field required. Master's degree preferred.
• Minimum of 2 years of varied hospital clinical experience required. Experience in case management, home health, and/or insurance industry preferre

Essential Functions

• Knows, understands, incorporates, and demonstrates the Organization's Mission, Vision, and Values in behaviors, practices, and decisions
• Meets medical center’s Guiding Behaviors and Caring Standards including interpersonal communication and professional conduct expectations.
• Demonstrates knowledge and skills to competently care for all assigned age groups (Neonate, Child, Adolescent, Adult, Geriatric as applicable).
• Revenue Management: ensure the accuracy of documenting services and supplies provided to the patients.
• Coordinates the integration of social services/case management functions into patient care, discharge, and home planning process with other hospital departments, external service organizations, agencies and healthcare facilities.
• Completes a screening/assessment of assigned cases to determine transition needs. Reassesses, monitors, and modifies transition needs as appropriate.
• Assists physicians with completing transfer and discharge orders. Maintains knowledge of federal, state, and private agency review requirements and regulations.
• Provides education to all health care team members including physicians regarding requirements to meet regulatory standards.
• Promotes effective and efficient utilization of clinical resources from admission to discharge.
• Completes PASRRs for admission to skilled nursing facilities.
• Researches and locates resources for patients for example: assistance in competing medication applications for financial assistance through pharmaceutical companies, works closely with our Patient Financial Advocates in the Medicaid pending process, and works closely with outside facilities to obtain equipment in situations when patients have limited funding available to them.
• Communicates with physicians at regular intervals throughout hospitalization and develops an effective working relationship. Assists physicians to maintain appropriate cost, cases, and desired patient outcomes.
• Introduces self to patient and family and explains clinical resource manager role and the process for patient and family to contact clinical resource manager.
• Serves as a patient advocate. Enhances a collaborative relationship to maximize the patient's and family's ability to make informed decisions.
• Participates in multidisciplinary patient care rounds and/or conferences as appropriate to review treatment goals, optimize resource utilization, provides family education and identification of post-hospital needs.
• Follows established patient choice policy.
• Documents assessment of primary and back up plans along with communications to patient, family and care team.
• Documents interventions taken to meet the needs of their individual patients in Power Chart.
• Actively participates in department staff meetings and department sub teams.
• Ensures discharge planning compliance with Medicare Conditions of Participation/regulations and Joint Commission standards,
• Coordinates Swing bed (SWB) admissions both from within the hospital and from other hospitals. Communicates and provides education to physician and patients/families regarding criteria. Completes and provides appropriate notices to patients/families.