RN Case Manager - Trauma Unit - Days

RN Case Manager

Location: Oklahoma City, Oklahoma

INTEGRIS Health Baptist Medical Center, Oklahoma's largest not-for-profit health system, has a great opportunity for a RN Case Manager with our Trauma Unit team.

Job Description:

• Work full-time from 8 a.m. to 4:30 p.m.
• Provide exceptional care to patients, managing clinical and financial outcomes for an assigned caseload.
• Facilitate patient care during hospitalization by managing, coordinating, and monitoring resource utilization.
• Proactively plan, coordinate, and negotiate efficient patient movement throughout the continuum of care.
• Function in roles including clinician, educator, researcher, manager, and advocate.
• Adhere to National Patient Safety Goals based on patient contact.

Responsibilities:

• Complete comprehensive assessments of patients' clinical, psychological, and financial needs.
• Recommend and coordinate timely transfers to appropriate levels of care.
• Develop, implement, evaluate, and revise discharge plans, including referrals.
• Communicate discharge care plans to patients, families, and healthcare professionals.
• Assist physicians and hospital staff in resource utilization and facilitate timely discharge planning.
• Coordinate services between hospital departments for timely discharges.
• Conduct concurrent reviews of patient records.
• Notify internal and external contacts of utilization issues affecting care and reimbursement.
• Facilitate patient transfers in accordance with policies and guidelines.
• Act as a resource and advisor to physicians regarding discharge planning and resource utilization.
• Manage established pathways to enhance clinical effectiveness and resource management.
• Maintain knowledge of CMS regulations, Medicare/Medicaid, managed care, and other payer regulations.
• Provide education on regulations and payer information to patients, families, and healthcare professionals.
• Develop and maintain knowledge of hospital and community resources.
• Identify opportunities to reduce patient care costs without impacting quality or outcomes.
• Participate in data collection for utilization and Quality Improvement reporting.
• Work collaboratively with patients, families, physicians, and healthcare professionals.

Mental Health Specific Responsibilities:

• Lead age-appropriate patient education and recreational groups.
• Document daily patient interactions and facilitate discharge planning.
• Participate in treatment team meetings and writing of treatment plans.
• Assist in utilization review process and serve as a patient advocate.
• Provide physician-ordered therapy and education on medications.
• Monitor vital signs and assess patient admission appropriateness.

Requirements:

• Required to be on call as scheduled.
• Potential exposure to infectious diseases and emotional stress.
• Occupational exposure to bloodborne pathogens as defined by OSHA.