Job Description
Integrated Healthcare Services is seeking a travel nurse RN Case Management for a travel nursing job in Albuquerque, New Mexico.
Job Description & Requirements
- Specialty : Case Management
- Discipline : RN
- Duration : 13 weeks
- 40 hours per week
- Shift : 8 hours
- Employment Type : Travel
Floating between departments and or local locations within 20 miles is required.
Job Summary :
Coordinating patient care across the continuum using assessment, care planning, implementation, coordination, monitoring and evaluation for cost effective and quality outcomes in a primarily inpatient setting. Responsible for facilitating members transfer from UNMH to Presbyterian Hospital when services are available.
Job Responsibilities :
Coordinates and facilitates the transfer of patients from UNMH to Presbyterian Hospital using the transfer center process flows (Presbyterian Care Connection).Once decision for admission is made, collects clinical information to determine patients level of care.Collaborates with Presbyterian Care Connection the transfer of member.Conducts an in-depth assessment which includes psychosocial, physical, medical, environmental and financial parameters.Collaborates with Healthcare team to proactively develop, implement and document, treatment and discharge plan, with appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs.Collaboratively formulates, implements, coordinates, monitors, and evaluates strategies with the healthcare team to address care management issues for specific patients and disease processes.Applies utilization review criteria to assess and document the appropriateness of admission, continued stay, level of care, and readiness for discharge; refers cases that do not meet criteria to designated Physician Advisor.Promotes the appropriate use of clinical and financial resources in order to improve quality of care and patient / member satisfaction.Performs cost-benefit analyses and refers to negotiations as needed, with non-contracted providers and vendors.Generates reports, which demonstrate efficacy through direct cost-savings and outcome measures.Actively participates in the development of clinical guidelines and pathways and incorporates processes into the role of nurse care coordinators.Educates providers and other PHS / PHP departments on health management strategies and care coordination services.Receives, reviews, verifies, and processes requests for approval of pre-service and concurrent services, supplies, and / or procedures, including but not limited to, inpatient hospitalizations, diagnostic testing, outpatient procedures and services, home health care services, durable medical equipment, and rehabilitative therapies.Performs retrospective review and conducts on-site or desktop audits at provider locations within New Mexico and completes all documentation accurately and appropriately.Upon completion of medical record validation and other retrospective audits, compiles detailed findings and relevant supporting documentation for review.Performs other functions as required.RightSourcing IHS Job ID #3-36489267. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined.
