What are the responsibilities and job description for the Case Management, In-House Registry position at University of Chicago Medicine?
Job Description
Be a part of a world-class academic healthcare system at UChicago Medicine as an Case Manager, In-House Registry (RN) at our main medical campus. In this role you will partner with the rest of the clinical team to provide patients the highest quality of care. Our Care Coordination team delivers the highest quality of care while ensuring continuation of care for our patients is a seamless process.
The Case Manager, as part of a multidisciplinary team, including physicians, and payers, ensures the patients progress in the acute episode of care through post discharge and is quality driven while being efficient and cost effective. This role works with the attending and consulting physicians to facilitate effective and efficient transition through the process of hospitalization; works collaboratively with all members of the multi disciplinary team to ensure patient needs are met and care delivery is coordinated across the continuum, as well as appropriately reimbursed by payers as contracted. The incumbent seeks the expertise of social workers to resolve psychosocial patient care issues and to develop complex patient transition/discharge plan as needed. The incumbent interacts with patients, family members, healthcare professionals, community, and state agencies in this effort.
The incumbent serves as a liaison between the hospital and community agencies or facilities for the exchange of clinical and referral information and is responsible for maintaining hospital compliance with the Quality Improvement Organization (QIO) series and CMS guidelines. In addition, the Case Manager provides case review information to third party payers, assists in the denial and appeals process, and assesses quality, levels of care and identifying and reporting potential risk management issues. The incumbent performs duties and tasks in accordance with performance standards established for the job. The incumbent is responsible for participation in and completion of all patient safety initiatives appropriate to the position. The incumbent conducts all job responsibilities according to the Mission and Values of the Hospital.
Essential Job Functions:
- Works in conjunction with physicians, nurses, inter disciplinary team and others to assess, plan and initiate patient plan of care and initiate patient plan of care
- Facilitates and coordinates details of actual discharge to appropriate agencies
- Conducts inpatient admission reviews for appropriateness of setting, admission status (IP/OP) and level of care (intensive care, general care)
- Using approved medical necessity criteria, conducts admission and continued stay review to ensure appropriateness of the setting and timely implementation of the plan of care, to monitor the patients progress along the continuum of care and intervenes as necessary to ensure appropriateness of setting and that the services provided are quality, efficient and cost effective
- Insures that all critical elements of the care and discharge plan have been communicated to multi-disciplinary team, patient and family including expediting teaching needs.
- Identifies, plans and facilitates strategies to reduce length of stay and inappropriate resource consumption, working in collaboration with attending and consulting physicians
Required Qualifications:
- Required Education: Associate Degree in Nursing; BSN degree or higher preferred. Associate Degree Nurses are required to enroll in a BSN program within six (6) to nine (9) months of hire, and make progress toward and complete their BSN degree within 30 months. ADN nurses receive 100% tuition reimbursement towards a BSN degree from an accredited program.
- A current Illinois Registered Nurse license
- 3 or more years of clinical experience
Preferred Qualifications:
- A Masters degree in Nursing from an NLN accredited school of nursing
- 5 years of clinical experience
- Certification in Case Management
Position Details:
- Job Type/FTE: Registry (.20 FTE)
- Shift: Days 8 hour shift
- Unit/Department: Care Coordination
- CBA Code: NNU National Nurses United
