RN - Patient Resource Manager (FT) Case Management
Company: Ballad Health
Location: Abingdon
Posted on: May 8, 2024
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Job Description:
*RN - Patient Resource Manager (FT) Case Management - Abingdon,
VA*Job ID: 004ETXJOHNSTON MEMORIAL HOSPITALNursing Support - Case
ManagementFull-time (scheduled 72 hrs or more per pay period) -
Day*Job Description**SCOPE OF POSITION*Patient Resource Management
is a comprehensive, coordinated approach to planning high quality
patient care for all patients from the neonate, infant, pediatric,
adolescent, adult and geriatric population (s). RN - Patient
Resource Managers function as the non-physician team leader and as
such assume overall responsibility for coordinating services,
programs, and personnel necessary to maximize patient outcomes and
quality care, ensuring efficient movement of the patient through
the continuum of care, and minimizing unnecessary resource
utilization in a selected group of patients. To perform this
function, the RN - Patient Resource Manager must have exceptional
clinical assessment and intervention skills to oversee the care
provided their assigned patient population. The RN - Patient
Resource Manager must review the patients status daily and identify
issues requiring intervention. They must anticipate, plan and
discuss patient needs with the patient and family, physician,
members of the interdisciplinary team, and third-party payers.As
the non-physician team leader, the RN - Patient Resource Manager
must ensure appropriateness and timeliness of medical interventions
and ancillary services. They are to ensure a collaborative and team
approach to patient care to minimize delays in care delivery and
ensure positive outcomes. The RN - Patient Resource Manager
oversees the collection of appropriate data that identifies
opportunities for improvement in service delivery and assists in
improving the efficiency and effectiveness of services when
appropriate. This individual must work closely with physicians and
intervene when barriers to care are encountered. In addition, this
individual will oversee clinical documentation in assigned patient
groups to ensure documentation is complete and accurately reflects
patients status and medical interventions completed.The RN -
Patient Resource Manager is responsible for ensuring ongoing
communication and collaboration with payer sources, achieving
appropriate pre-certification and ongoing concurrent certification
such that Ballad Health is paid appropriately for services
provided. As such, the individual must have an in-depth knowledge
and ability to apply various payer's rules and regulations,
admission, discharge and continued stay reimbursement criteria and
both Interqual and Milliman Guidelines. The RN - Patient Resource
Manager must ensure that patients are admitted appropriately, and
that continued care is appropriate for their clinical needs in the
appropriate place in the continuum. While the RN - Patient Resource
Manager must monitor resource management and cost effectiveness of
care for their assigned patient population; patient safety and
achieving positive clinical outcomes will always be the ultimate
guiding force in the Patient Resource Managers position.As part of
this role, the RN - Patient Resource Manager must also oversee the
discharge planning process including plan development,
implementation, education and acquisition of resources for a
successful discharge. The RN - Patient Resource Manager oversees
utilization of patient care protocols and clinical pathways and
ensures appropriate patient and family education has occurred prior
to discharge. This individual demonstrates competency in the care
of Neonate, Infant, Child, Adolescent, Adult, Geriatric
patients.*REPORTING RELATIONSHIP*See Table of
Organization.*EDUCATION AND EXPERIENCE*Associate's or Bachelor's
degree from an accredited Nursing program. Varied clinical
experience. Experience in Quality, Case Management, Utilization
Review, or similar field is preferred.Valid and active RN licensure
in appropriate state*Requirements*No additional requirements from
any stated in the above description.Job Type: Full-timeby
Jobble
Keywords: Ballad Health, Kingsport , RN - Patient Resource Manager (FT) Case Management, Executive , Abingdon, Tennessee
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