What are the responsibilities and job description for the RN Case Manager position at Children's National Medical Center?
Description All nursing practice is based on the legal scope of practice, national and specialty nursing standards, Children's National Policies and Procedures, and in accordance with all applicable laws and regulations. The Professional Model of Care requires registered professional nurses to be responsible and accountable for their own practice. Children's National supports the development of RN relationships within the community; specifically those relationships associated with the health and well being of the community at large.
Qualifications Minimum Education
Bachelor's Degree (Required)
Minimum Work Experience
5 years With at least three in clinical nursing. At least one year experience in Utilization Management with knowledge of utilization review criteria. Experience in one or more of the following areas: case management, designated/pediatric specialty (Required)
Functional Accountabilities
Professional Practice/Research
Organizational Accountabilities
Organizational Accountabilities (Staff)
Organizational Commitment/Identification
Teamwork/Communication
Performance Improvement/Problem-solving
Cost Management/Financial Responsibility
Safety
Bachelor's Degree (Required)
Minimum Work Experience
5 years With at least three in clinical nursing. At least one year experience in Utilization Management with knowledge of utilization review criteria. Experience in one or more of the following areas: case management, designated/pediatric specialty (Required)
Functional Accountabilities
Professional Practice/Research
- Participate in Shared Leadership.
- Contribute to the MAGNET Journey of Children's National.
- Ensure that nursing practice is based on evidence of best practice.
- Accountable for participating in the Nursing Division's Performance Improvement process (division or unit level).
- Participate in community activities.
- Conduct timely clinical reviews drawing upon appropriate resources and apply nationally recognized criteria to support medical necessity of patient observation admission or inpatient admission and continued hospitalization.
- Address treatment delay, potential and actual denials with the Attending physician and other relevant members of the healthcare team.
- Provide clinical reviews to third party payers and validates authorization or denial of services from them.
- Document approved and denied services in STAR to facilitate meaningful data analysis.
- Communicate verbally and/or written e.g., email) with payers and healthcare team in a clear, timely, accurate and professional manner and/or organized in a professional format.
- Speak up when team members appear to exhibit unsafe behavior or performance
- Continuously validate and verify information needed for decision making or documentation
- Stop in the face of uncertainty and takes time to resolve the situation
- Demonstrate accurate, clear and timely verbal and written communication
- Actively promote safety for patients, families, visitors and co-workers
- Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance
Organizational Accountabilities
Organizational Accountabilities (Staff)
Organizational Commitment/Identification
- Anticipate and responds to customer needs; follows up until needs are met
Teamwork/Communication
- Demonstrate collaborative and respectful behavior
- Partner with all team members to achieve goals
- Receptive to others' ideas and opinions
Performance Improvement/Problem-solving
- Contribute to a positive work environment
- Demonstrate flexibility and willingness to change
- Identify opportunities to improve clinical and administrative processes
- Make appropriate decisions, using sound judgment
Cost Management/Financial Responsibility
- Use resources efficiently
- Search for less costly ways of doing things
Safety
- Speak up when team members appear to exhibit unsafe behavior or performance
- Continuously validate and verify information needed for decision making or documentation
- Stop in the face of uncertainty and takes time to resolve the situation
- Demonstrate accurate, clear and timely verbal and written communication
- Actively promote safety for patients, families, visitors and co-workers
- Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance
Primary Location: District of Columbia-WASHINGTON
Work Locations:
Sheikh Zayed Campus
111 Michigan Avenue
Washington 20010
Job: Nursing
Organization: Patient Services
Position Status: R (Regular) - FT - Full-Time
Shift: Day
Work Schedule: M-F 08:30 AM to 5:30 PM
Job Posting: Jan 16, 2024, 4:30:06 PM
Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individual with Disabilities.