RN Case Manager

Crozer-Keystone Health System Crum Lynne , PA 19022

Posted 2 months ago

RN Case Manager # The RN Case Manager will be expected to provide clinical support to the Internal Medicine Physicians of Crozer Keystone Health Network, and will perform duties in support of the Crozer-Keystone Health System mission to ensure the highest quality of patient care in an economically sound and efficient manner. # The Case Manager should have the ability to work with electronic patient registries, and will develop nursing care plans and appropriate follow-up of high-risk patients; scheduling appointments as necessary.# # The Case Manager will perform and/or monitor quality assurance programs at the practice and/or Network level.# The Case Manager will assist in developing clinical policies, and in conjunction with the Practice Manager, may have some clinical supervisory responsibilities for the Medical Assistants.


Education and Training:


Current licensure to practice Professional Nursing in the Commonwealth of Pennsylvania


Experience:


Previous physician practice experience helpful. Previous knowledge of healthcare insurance helpful.


Diabetic Teaching and Education experience preferred


.# Project Management experience helpful.# Triage experience for patient calls.# # Registration, Licensure and/or Certification: Current licensure to practice Professional Nursing in the Commonwealth of Pennsylvania, Case Management certification preferred.# CDE (Certified Diabetes Educator) preferred. # # An ideal candidate would possess the following: # Demonstrated customer service, communication and interpersonal skills. Knowledge of healthcare insurance; particularly as it relates to diabetic coverages Knowledge of Practice Management/Electronic Medical Record Systems, preferably with Cerner/Centricity. Working knowledge of Microsoft Office Knowledge of ICD-10 # The primary responsibilities of this position include: # Performs/monitors quarterly quality assurance reports and proficiency testing for CCMC, the PA Department of Health and CAP (College of American Pathologists), etc. Monitors patients on the Anticoagulation Management Service. Monitors the Influenza Immunization Project, in conjunction with the Lead MA/Medical Assistants. Assists with applications for patients requiring assistance with medication through Indigent Programs provided by pharmaceutical companies. Maintains patient education file for physician and residency program. Assist physicians, as needed, in preparation, procedures with patients, correctly identifying patient/family concerns problems or prescription needs.# Documents all actions above in the patient record. Obtains a comprehensive health history from Ancillary services, (i.e. Home Care, Pharmacy, PT/OT, COSA, etc.) on patients, which includes medical and social information.# Assesses the patients# needs and utilizes the nursing process with physician recommendation to formulate plan of care and referral if needed.# Educates patients and families on matters related to physician#s instructions, diet, medication and other matters related to the patients# physical well-being. Prepares office/staff in guidelines for The Joint Commission (TJC) and other mandated inspections in conjunction with Practice Manager. Lead the practices efforts to comply with all Quality initiatives. Work with physicians, staff, patients and quality team to achieve all aspects of CPC+ by improving processes for which we care for chronic illnesses.# Process should result in permanent practice change. Create and manage reporting for PDSA cycles (e.g. foot exams, eye exams, staff huddles, patient education material, etc.) Routinely maintain patient registry; high-risk registry for reporting purposes. Routinely monitor the practice#s progress in meeting CPC+/Quality goals/ratings.# Collaborate with the Practice Manager to make adjustments to work flows if goals are not being achieved. Determine staff workflow to support protocols and templates coordinating the efforts for front office staff, MA, physicians and patients to meet standardized protocols across the practice Routinely meet with the MA staff/physicians to ensure compliance to quality goals. Work directly with patients who need assistance meeting their self-management goals (obtaining referrals, getting to appointments, keeping timely appointments, etc.)# Work with physicians on compliance plans.# Work with patients to achieve their compliance plans. Trains clinical staff.


As needed


, assists manager with hiring and supervision. Work with physicians on compliance plans.# Work with patients to achieve their compliance plans. Identifies high risk patient population (based on clinical condition and/or psychosocial circumstances and care history) for their ability to benefit from care coordination.# Maintains a high risk registry.# Develops care plan interventions for high-risk patients. Schedules hospital follow-up visits with PCP within 5-7 days, when possible. Assists physicians, as needed, in preparation, procedures with patients, correctly identifying patient/family concerns. Communicates patient needs/plan of care/status and/or changes with office staff/physicians. Provides diabetic teaching; including insulin injection, diet/exercise, education and overall diabetic education. Develops reference base for community resources to support patient#s condition(s), and makes referrals when appropriate. Applying the nursing process, will collaborate with primary clinician and other team members (specialists, home care nurses and therapists) to develop goals and plan interventions; Using the principles of self-management support, works with patients/family on an on-going basis to support the care coordination plan including providing education, maintaining telephone contact, arranging community resources, scheduling health care services, etc. Provides Transition Care after ED/hospital discharge; does telephonic review of discharge plan with patient 24-48 hours post discharge.# Does targeted assessment of patient#s abilities/limitation; does medication reconciliation.# Manages ED/Hospital Discharge reports. Assists with clinical competencies of the medical assistants. As needed, assists manager with annual evaluations on medical assistants and staff employees. When needed, rooms patients, performs venipuncture, administers injections, administers oral medications and performs other clinical testing as instructed by the physician in accordance with recommended procedures, blood borne pathogen policies, OSHA regulations, CLIA regulations and other established policies and procedures. Notifies patients of all testing results as instructed by physician. Triages patient calls, collecting pertinent information.# Provides information, instructions and/or an appointment as appropriate.# Determines level of urgency and notifies physician accordingly. # When needed, monitors staff#s efficiency in ordering adequate inventory of medical and, pharmaceutical supplies. When needed, provides annual in-service and CPR Re-certification for staff. # # # # # # # *Indicates the essential functions of this position. The above statements are intended to describe the most frequently performed duties of the job.# Other related duties may be assigned.

RN Case Manager

The RN Case Manager will be expected to provide clinical support to the Internal Medicine Physicians of Crozer Keystone Health Network, and will perform duties in support of the Crozer-Keystone Health System mission to ensure the highest quality of patient care in an economically sound and efficient manner.

The Case Manager should have the ability to work with electronic patient registries, and will develop nursing care plans and appropriate follow-up of high-risk patients; scheduling appointments as necessary.

The Case Manager will perform and/or monitor quality assurance programs at the practice and/or Network level. The Case Manager will assist in developing clinical policies, and in conjunction with the Practice Manager, may have some clinical supervisory responsibilities for the Medical Assistants.

Education and Training: Current licensure to practice Professional Nursing in the Commonwealth of Pennsylvania

Experience: Previous physician practice experience helpful. Previous knowledge of healthcare insurance helpful. Diabetic Teaching and Education experience preferred. Project Management experience helpful. Triage experience for patient calls.

Registration, Licensure and/or Certification: Current licensure to practice Professional Nursing in the Commonwealth of Pennsylvania, Case Management certification preferred. CDE (Certified Diabetes Educator) preferred.

An ideal candidate would possess the following:

  • Demonstrated customer service, communication and interpersonal skills.

  • Knowledge of healthcare insurance; particularly as it relates to diabetic coverages

  • Knowledge of Practice Management/Electronic Medical Record Systems, preferably with Cerner/Centricity.

  • Working knowledge of Microsoft Office

  • Knowledge of ICD-10

The primary responsibilities of this position include:

  • Performs/monitors quarterly quality assurance reports and proficiency testing for CCMC, the PA Department of Health and CAP (College of American Pathologists), etc.

  • Monitors patients on the Anticoagulation Management Service.

  • Monitors the Influenza Immunization Project, in conjunction with the Lead MA/Medical Assistants.

  • Assists with applications for patients requiring assistance with medication through Indigent Programs provided by pharmaceutical companies.

Maintains patient education file for physician and residency program.

  • Assist physicians, as needed, in preparation, procedures with patients, correctly identifying patient/family concerns problems or prescription needs. Documents all actions above in the patient record.

  • Obtains a comprehensive health history from Ancillary services, (i.e. Home Care, Pharmacy, PT/OT, COSA, etc.) on patients, which includes medical and social information. Assesses the patients' needs and utilizes the nursing process with physician recommendation to formulate plan of care and referral if needed.

  • Educates patients and families on matters related to physician's instructions, diet, medication and other matters related to the patients' physical well-being.

  • Prepares office/staff in guidelines for The Joint Commission (TJC) and other mandated inspections in conjunction with Practice Manager.

  • Lead the practices efforts to comply with all Quality initiatives. Work with physicians, staff, patients and quality team to achieve all aspects of CPC+ by improving processes for which we care for chronic illnesses. Process should result in permanent practice change.

  • Create and manage reporting for PDSA cycles (e.g. foot exams, eye exams, staff huddles, patient education material, etc.)

  • Routinely maintain patient registry; high-risk registry for reporting purposes.

  • Routinely monitor the practice's progress in meeting CPC+/Quality goals/ratings. Collaborate with the Practice Manager to make adjustments to work flows if goals are not being achieved.

  • Determine staff workflow to support protocols and templates coordinating the efforts for front office staff, MA, physicians and patients to meet standardized protocols across the practice

  • Routinely meet with the MA staff/physicians to ensure compliance to quality goals.

  • Work directly with patients who need assistance meeting their self-management goals (obtaining referrals, getting to appointments, keeping timely appointments, etc.) Work with physicians on compliance plans. Work with patients to achieve their compliance plans.

  • Trains clinical staff. As needed, assists manager with hiring and supervision.

  • Work with physicians on compliance plans. Work with patients to achieve their compliance plans.

  • Identifies high risk patient population (based on clinical condition and/or psychosocial circumstances and care history) for their ability to benefit from care coordination. Maintains a high risk registry.

  • Develops care plan interventions for high-risk patients.

  • Schedules hospital follow-up visits with PCP within 5-7 days, when possible.

  • Assists physicians, as needed, in preparation, procedures with patients, correctly identifying patient/family concerns.

  • Communicates patient needs/plan of care/status and/or changes with office staff/physicians.

  • Provides diabetic teaching; including insulin injection, diet/exercise, education and overall diabetic education.

  • Develops reference base for community resources to support patient's condition(s), and makes referrals when appropriate.

  • Applying the nursing process, will collaborate with primary clinician and other team members (specialists, home care nurses and therapists) to develop goals and plan interventions;

  • Using the principles of self-management support, works with patients/family on an on-going basis to support the care coordination plan including providing education, maintaining telephone contact, arranging community resources, scheduling health care services, etc.

  • Provides Transition Care after ED/hospital discharge; does telephonic review of discharge plan with patient 24-48 hours post discharge. Does targeted assessment of patient's abilities/limitation; does medication reconciliation. Manages ED/Hospital Discharge reports.

  • Assists with clinical competencies of the medical assistants.

  • As needed, assists manager with annual evaluations on medical assistants and staff employees.

  • When needed, rooms patients, performs venipuncture, administers injections, administers oral medications and performs other clinical testing as instructed by the physician in accordance with recommended procedures, blood borne pathogen policies, OSHA regulations, CLIA regulations and other established policies and procedures.

  • Notifies patients of all testing results as instructed by physician.

  • Triages patient calls, collecting pertinent information. Provides information, instructions and/or an appointment as appropriate. Determines level of urgency and notifies physician accordingly.

  • When needed, monitors staff's efficiency in ordering adequate inventory of medical and, pharmaceutical supplies.

  • When needed, provides annual in-service and CPR Re-certification for staff.

  • Indicates the essential functions of this position.

The above statements are intended to describe the most frequently performed duties of the job. Other related duties may be assigned.

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