RN-Case Manager, Home Health

Company: SSM Health
Location: Madison
Posted on: January 14, 2021

Job Description:

PRIMARY RESPONSIBILITIES

• Ensures compliance with Condition of Participation (CoP) discharge planning.
• Identifies and escalates gaps/barriers related to inpatient and observation length of stay.
• Assesses patients at high risk for readmission. Identifies root cause for readmission. Develops plan and collaborates with multidisciplinary team regarding discharge planning to next level of care.
• Participates with other members of team regarding opportunities for improvement in standard work.
• May also be responsible for: utilization management process, ED case management process, admission process, and act as a case manager liaison with post acute providers (skilled nursing facilities, rehab, home health, etc.).
• Applies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient's age-specific needs and clinical needs as described in the department's Scope of Service.
• As an SSM Health nurse, I will demonstrate the professional nursing standards defined in the professional practice model. Uses the ANA Code of Ethics for Nurses to guide his/her response to the current and evolving health and nursing needs of our patients and our patient populations.
• Works in a constant state of alertness and safe manner.
• Performs other duties as assigned.EDUCATION
  • Graduate of accredited school of nursingEXPERIENCE
    • Three years' acute care experiencePHYSICAL REQUIREMENTS
      • Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
      • Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
      • Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
      • Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
      • Frequent keyboard use/data entry.
      • Occasional bending, stooping, kneeling, squatting, twisting and gripping.
      • Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
      • Rare climbing.

Keywords: SSM Health, Madison , RN-Case Manager, Home Health, Executive , Madison, Wisconsin