Description NURSE CARE MANAGER JOB SUMMARY - The Nurse Care Manager (NCM) demonstrates expert knowledge of clinical systems available internally and externally which impact patient care throughout the continuum of healthcare services.
ESSENTIAL FUNCTIONS OF POSITION - Utilizes the nursing process to collaborate with the interdisciplinary team.
- Assesses planning, coordinating, implementing, monitoring and evaluating patient care.
- Accesses resources available to the patient, facilitating high quality and cost effective patient outcomes across the continuum of care.
- Participates in the development of the Interdisciplinary treatment plan and the provision of education.
- Ensures an effective discharge planning process and follow-up.
- Demonstrates competencies for patient population served
- Complies with department and hospital policies and procedures.
- Participates in continuing education, performance improvement, and functions with a focus on patient safety and customer service.
- Promotes and facilitates a philosophy of family-centered care.
- Advocates for the patient, working to facilitate an optimal situation for the patient, the healthcare team and the payer which is focused on quality care in a cost effective manner.
- A direct contact and accessor of resources which impact the patient's plan of care.
- An educator for the patient/family and members of the healthcare team regarding case management, community resources, benefit systems and cost analysis
- A facilitator of communication and coordination within the interdisciplinary team in conjunction with the patient, promoting quality care and cost effective individualized treatment goals, which enhance the physical, psychosocial, developmental and educational health of the patient.
- A manager of resource utilization, coordinating services and reimbursement.
- Participates in developing, evaluating and revising clinical pathways.
- Analyzes and utilizes aggregate variance and trend data to improve clinical, quality and financial outcomes.
POSITION REQUIREMENTS Educational Requirements
- Graduate from NLN accredited school of nursing. Baccalaureate degree in Nursing preferred.
Licensure, Certification and Registration
- Current CPR. Case Management Certification within one year of eligibility preferred. Current license to practice as an RN in the State of Maryland.
Work Orientation and Experience
- BSN preferred. Minimum three years recent applicable nursing experience required. One year pediatric and Case/Care Management experience preferred. Experience with discharge planning and inter-agency coordination preferred. Active membership in professional organizations is highly desirable, such as: Case Management Society of America, American Case Management Association.
Knowledge, Skills and Abilities
- Knowledge of the Nurse Practice Act, ANA Code of Ethics and Standards of
- Practice and Performance
- Demonstrates skills in organization and coordination of care for complex care for patients
- Knowledge of third party payer systems including Medicaid and Managed Care
- Tact and sensitivity
- Knowledge of growth and development for infants through young adults
- Good computer knowledge and skills
- Ability to analyze databases, draw conclusions and facilitate the change process
- Attains and maintains high level of skill and proficiency in interpersonal and written and verbal communication skills
- Ability to influence and negotiate individual and group decision-making
- Ability to establish effective and collaborative working relationships
- Detail oriented
- Ability to manage time, organize and multi-task
- Ability to follow-up and follow-through to ensure a timely and effective
- Discharge
- Ability to negotiate and building collaborative relationships
- Ability to walk, run, sit, stoop, stand, bend, push, pull, demonstrate mobility and manual dexterity, and have visual and auditory ability to do this job
REPORTING RELATIONSHIPS Supervision Received
- Reports to the Director of Care Management/Social Work/Admissions
Supervision Exercised
INTERPERSONAL RELATIONSHIPS - Collaborates with physicians, unit managers, staff, members of the health care team and health care systems staff to promote collegial relationships with internal and external health care providers and members of the interdisciplinary team.
TOOLS/EQUIPMENT USED - Computer hardware and software to support job requirements. Communication technology (telephone, fax, pager, etc)
PHYSICAL ENVIRONMENT/WORKING CONDITIONS - Risk of exposure to body fluids and infectious waste requiring the use of personal protective equipment. Occasionally subjected to irregular hours. Frequent stress due to emergency situations or multiple demands.
This job description identifies the general nature and level of work to be performed. It is not to be considered an exhaustive list of responsibilities, duties or skills required of an incumbent.