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Job Details

RN Contract - Case Coordinator

Requisition #: 547891
Location: Sibley Memorial Hospital, Washington, DC 20016
Category: Nursing Support/Patient Care
Work Shift: Day Shift
Work Week: Temporary
Weekend Work Required: Yes
Date Posted: July 1, 2022

GENERAL SUMMARY: This is a 13 week contract. The Case Coordinator - Registered Nurse evaluates timeliness and appropriateness of patient care, and coordinates discharge or transition planning for a smooth progression to post-hospital care.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  1. Evaluates timeliness and appropriateness of patient care by reviewing medical record, meeting with physician and other patient care providers and comparing planned care to industry standard observation and hospitalization criteria adopted by payers.
  2. Identifies delays in progression of patient care related to tests, treatments, procedures or specialty evaluations through ongoing evaluation of the patient and medical record. Negotiates with internal providers to promote timely progression of the patients’ plan of care.
  3. Identifies patients with complex discharge planning needs. Recommends options for post hospital care based on required services and available resources. Works collaboratively with physician, patient, other patient care providers and family members as appropriate to develop discharge plan.
  4. In conjunction with the nurse manager or charge nurse, facilitates multidisciplinary meetings as needed to discuss selected complex and challenging cases and to develop specialized multidisciplinary plans for post hospital care.
  5. Attends multidisciplinary planning meetings with other health care team members to facilitate the interdisciplinary care of patients and achievement of positive outcomes, e.g. promoting optimal length of stay, avoiding insurance and audit denials, improving patient satisfaction scores especially in the Discharge Domain, increasing employee engagement and post-hospital plans of care.
  6. Documents case coordination activities into the Epic Computerized Patient Record and utilization and financial information into Auth/Cert section of Epic.
  7. Accepts utilization and discharge planning related verbal (one-off) orders from physicians, reads them back to the physician, documents in the medical record and communicates to appropriate patient care providers.
  8. Serves as liaison to payers to provide information regarding appropriateness of hospitalization.
  9. Serves as liaison to external providers and payers to arrange for appropriate post hospital services.
  10. Facilitates transfer of information among healthcare professionals to promote smooth patient transition between services and settings of care.
  11. Identifies patients with special age specific needs for protective services such as court appointed conservator or child/adult protective services and makes referral.
  12. Identifies patients with special age specific needs for post hospital care related to decreased independence in the elderly. Recommends appropriate community resources.
  13. Identifies patients with special age specific needs for post hospital care related to home care of a newborn. Recommends appropriate community resources.
  14. Identifies cases with questions regarding medical necessity of observation, admission or continued stay, appropriateness of hospital services or quality of care concerns to refer to a departmental secondary reviewer. When there are unresolved related issues, a review will be conducted by a Physician Advisor member of Clinical Resource Management Committee.

Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

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