PRN Case Management Discharge Planning Job Listing at MedStar Medical Group in Washington, DC (Job ID 71705)

Description

General Summary of Position

MedStar Georgetown University Hospital

Monitors the care and services delivered to selected patient populations during the acute hospital stay, promotes effective utilization of resources, and assumes a leadership role with the interdisciplinary team to achieve optimal clinical and resource outcomes for the acute, and posthospital phases of care. Develops and maintains a positive work climate and supports the overall team effort of the health system. The functions are performed in accordance with all applicable laws and regulations and MedStar Georgetown University Hospital's philosophy, policies, procedures, and standards.

Minimum Qualifications
Education

• Registered Nurse, Required
• BSN Preferred

Experience

• 3-4 years Three years clinical experience in an acute care setting. Required
• Utilization management and/or case management experience Preferred

Licenses and Certifications

• Licensed to practice in the District of Columbia for appropriate professional discipline; Required and
• Specialty certification Preferred

Knowledge, Skills, and Abilities

• Advanced communication and interpersonal skills.
• Demonstrated ability to manage information for the purpose of setting goals and measuring success.
• Willingness and ability to explain case management, managed care and reimbursement concepts and requirements to patients, families, and staff.
• Willingness and ability to coach colleagues and new staff in areas of professional expertise.
• Ability to determine when a referral to other departments is required by the patients clinical, social, or financial situation.
• Ability to interact with clinical departments as necessary to clarify components of the treatment or discharge plan.
• Ability to maintain effective communication with all members of the care team: patient, family, and hospital colleagues.
• Skill and proficiency in applying highly technical principles, concepts and techniques that are central to the health care professions.



Primary Duties and Responsibilities


• Assesses, facilitates, and monitors the plan of care in conjunction with the patient and/or family/significant other. Communicates the need, or lack of, continued hospitalization and ensures patient understanding of third party payer guidelines.
• Conducts concurrent chart review of selected patient populations, assesses the appropriateness of the level of care, diagnostic testing and clinical procedures, quality and clinical risk issues, and completeness of medical record documentation.
• Reviews all patient admission data within the designated timeframes to determine the suitability of the level of care in accordance with established guidelines.
• Identifies issues/problems and makes appropriate recommendations. Communicates with patients, families/significant others, medical staff, caregivers, and third-party payers, as necessary.
• Coordinates care within GUH and other settings by monitoring and overseeing the continuum of clinical care, ensuring necessary meetings are held with patient/family and the interdisciplinary team to coordinate treatment and discharge plans. Arranges discharge-planning referrals as ordered by patient's physician.
• Serves as a facilitator/advocate for patients and families in the resolution of problems related to the established plan of care and procurement of services.
• Monitors the daily activity of on-site reviewers for consistency and correctness in the application of standards for admission and continued stay.
• Produces case documentation in approved manual or electronic format while maintaining required departmental standards and protocols.
• Participates in the development and standardization of improved pathway and best practice scenarios.
• Exemplifies Guest and Staff Relations standards in all activities.
• Assumes other duties and responsibilities that are appropriate to the position and area. The above responsibilities are a general description of the level and nature of the work assigned to this classification and are not to be considered as all-inclusive.



About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.