Job Information
Actalent RN Case Manager in Riverside, California
Description:
They are making discharge plans, helping with the care plan with the doctors, less busy than ED. - Plans, develops, assesses & evaluates care provided to members. - Collaborates with physicians, other members of the multidisciplinary health care team & patient/family in the development, implementation & documentation of appropriate, individualized plans of care to ensure continuity, quality & appropriate resource use. - Recommends alternative levels of care & ensures compliance with federal, state & local requirements. - Assesses high risk patients in need of post-hospital care planning. - Develops & coordinates the implementation of a discharge plan to meet patient's identified needs. - Communicates the plan to physicians, patient, family/caregivers, staff & appropriate community agencies. - Reviews, monitors, evaluates & coordinates the patient's hospital stay to assure that all appropriate & essential services are delivered timely & efficiently. - Participates in the Bed Huddles & carries out recommendations congruent with the patient's needs. - Coordinates the interdisciplinary approach to providing continuity of care, including Utilization management, Transfer coordination, Discharge planning, & obtaining all authorizations/approvals as needed for outside services for patients/families. - Conducts daily clinical reviews for utilization/quality management activities based on guidelines/standards for patients in a variety of settings, including outpatient, emergency room, inpatient & non-KFH facilities. - Acts as a liaison between in-patient facility & referral facilities/agencies & provides case management to patients referred. - Refers patients to community resources to meet post hospital needs. - Coordinates transfer of patients to appropriate facilities; maintains & provides required documentation. - Adheres to internal & external regulatory & accreditation requirements & compliance guidelines including but not limited to: TJC, DHS, HCFA, CMS, DMHC, NCQA & DOL. - Educates members of the healthcare team concerning their roles & responsibilities in the discharge planning process & appropriate use of resources. - Provides patients with education to assist with their discharge & help them cope with psychological problems related to acute & chronic illness. - Per established protocols, reports any incidence of unusual occurrences related to quality, risk and/or patient safety which are identified during case review or other activities. - Reviews, analyses & identifies utilization patterns & trends, problems or inappropriate utilization of resources & participates in the collection & analysis of data for special studies, projects, planning, or for routine utilization monitoring activities. - Coordinates, participates & or facilitates care planning rounds & patient family conferences as needed. - Participates in committees, teams or other work projects/duties as assigned.
Skills:
Case management, Acute care, discharge planning
Top Skills Details:
Case management,Acute care,discharge planning
Additional Skills & Qualifications:
2 years of experience as a clinical nurse in an acute care setting, needs to know the flow of hospitals 6 months exp of case management, discharge planning
Experience Level:
Intermediate Level
About Actalent:
Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day, our experts around the globe are making an impact. We’re supporting critical initiatives in engineering and sciences that advance how companies serve the world. Actalent promotes consultant care and engagement through experiences that enable continuous development. Our people are the difference. Actalent is an operating company of Allegis Group, the global leader in talent solutions.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.