IP Care Management Consultant I

Job description

GENESIS HEALTHCARE SYSTEM In order to fill our Mission of serving our community by helping each person achieve optimal health and well-being by providing compassionate, exceptional, and affordable healthcare services, all employees of Genesis HealthCare System must be committed to living the Genesis Mission and Genesis values of Compassion, Excellence, Integrity, Team, and Innovation. All employees must regard themselves as an ‘owner’ of Genesis and keep our patients at the center of everything we do - always. Position Details: Work Shift: Day Shift (United States of America) Scheduled Weekly Hours: 32 Department: Inpatient Care Management Overview of Position: The RN Care Manager or Social Worker Care Manager acts as part of a multidisciplinary team to ensure the patient’s progress across the continuum is efficient, with quality patient care. The Care Manager will provide discharge planning coordination and intervention for all inpatients and to observation / outpatients as needed. They intervene with patients who have complex psychosocial needs. They offer crisis intervention to patients and families and coordinate the development of a discharge plan for high-risk patient populations. The goal of the Care Manager is to promote patient wellness, reduce re-admission rates, and improve patient care outcomes. ESSENTIAL DUTIES  Throughput & Coordination of Hospital Care: Interacts on a regular and consistent basis with physicians, nursing staff, and utilization review staff on patient care, resource utilization & observation issues. Actively involves the physicians to prevent delays and improve patient outcomes concurrently. Identifies and resolves delays and obstacles to discharge.  Patient Goals of Care & Care Plan: Collaborates with patient/family in establishing mutual goals based on patient/s needs or problems. Educates and instills confidence in the patient’s/caregiver’s own ability to optimize their own health. Works with them to help them integrate health status changes into their life. Ensures that the plan of care and services are patient focused, high quality  Multidisciplinary Rounds: Facilitates & participates in care coordination, multidisciplinary rounds for your assigned district. Provides appropriate information in order to facilitate and develop an individualized continuing care plan in collaboration with patients and physicians.  Readmission Reviews: Meets with patients and family members to assess living arrangements prior to admission, evaluate factors that may have contributed to 30-day readmission, and actively works with family to identify resources available to meet their challenges. Facilitates & utilizes family conference meetings when appropriate. Create care plans for continuum of care, if applicable.  Discharge Checklist: Ensures that all elements of CMS discharge checklist along with patient’s plan of care have been communicated to the patient/family and members of the healthcare team and are documented in Epic EMR per CMS and department standards and to assure continuity of care.  Patient Safety: Ensures safe care to patients adhering to policies, procedures, and standards.  Psych Precertification: Completes pre-certs for inpatient psychiatric admissions, on weekends when required.  Transitions of care and Post discharge follow-up process: Provides patient with follow-up case management contact information to ensure initiation of home services, medication needs are met, along with ensuring that the patient/family has someone to call with follow-up questions. Ensures that transitions of care are completed, and patient is connected with appropriate system wide care management.  Social Workers Follows the ethical codes as established by the State of Ohio Counselor and Social Work Board. Intervenes with patients and families regarding emotional, social, and financial consequences of illness and or disability access and mobilizes family and community resources to meet the identified needs. Examples are Pre-admission Screening form for Mental Illness and Mental Retardation, verifies appropriateness of patient need for guardianship and follows procedure according to state law and hospital policy, and demonstrates knowledge of all Medicaid waiver programs and makes referrals as appropriate. QUALIFICATIONS 1. Current Ohio RN licensure, Licensed Social Worker (LSW) or Counselor (LPC) in the State of Ohio. Licensure. a. If RN, must also have BSN with 3 years of clinical RN experience or ADN with 7 years of clinical RN experience. b. If LSW or LPC, Bachelor’s degree in Social Work. 2. Ability to perform data analysis and to utilize computer systems to record and communicate information to other services. 3. Excellent verbal and organizational skills to order to steer the case management process. PATIENT CENTERED CARE & BEHAVIORAL EXPECTATIONS 1. Living the Genesis Mission, Vision and Values • Performs work in a manner that is quality focused. • Treats patients, co-workers, visitors and volunteers with courtesy, compassion, empathy and respect. • Results oriented and focused on achievement of objectives. • Acknowledges and responds to the diversity of people and the situation. • Encourages peers (others) to be owners of change. • Always makes the effort to anticipate and exceed customer needs and expectations. • Possesses the ability to engage others with patience and understanding. • Acts in a manner that creates positive first and lasting impressions. • Demonstrates the ability to own issues until they are resolved. 2. Patient Centered Care (patients/families, physicians, co-workers, all other internal/external customers) • Introduces self and role…connects with everyone. • Communicates effectively (i.e. advising others of actions, pertinent information, time durations, etc.) and asks for feedback. • Asks for and anticipates needs and concerns of others. • Maintains a positive work environment for staff and a healing environment for patients (i.e. safe, clean, quiet, etc.) • Maintains the dignity and privacy of each person; manages confidential/sensitive information appropriately. • Responds to requests in an appropriate and timely manner. • Exits patient/customer encounters courteously, asking if there are additional needs that can be addressed. 3. Promotes Patient and Employee Safety • Demonstrates safe Patient Handling (i.e. transfers, transport, care administration, nutrition, medication, etc.) • Demonstrates safe Materials Handling (i.e. appropriate use and disposal of chemicals, infectious wastes, etc.) • Demonstrates appropriate knowledge of Infectious Disease precautions and use of proper protective equipment • Demonstrates Slips/Trips and Falls Awareness. • Actively contributes to maintaining a safe, clean and quiet environment. WORKING CONDITIONS/PHYSICAL REQUIREMENTS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Must have excellent written and verbal communication skills as well as the ability to observe, access, guide and evaluate others. 2. Must be able to hear, speak, see and to coordinate motor skills. 3. Must be able to climb, lift25 pounds, stoop and bend. 4. Ability to collect data, interpret findings, set priorities and carry out established plan. 5. Ability to read, write and utilize manual and computerized systems of documentation. 6. Must read a significant amount of information in a relatively short period of time. Thank you for your interest in employment at Genesis. Genesis is committed to being an equal opportunity employer. Selection of applicants for employment is based only on qualifications and the requirements of a specific job.