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Case Manager ED

Company: AHMC Healthcare
Location: Anaheim
Posted on: November 16, 2022

Job Description:

The ED RN Case Manager uses InterQual criteria to evaluate the appropriateness of admissions, level of care, and readiness for discharge. - Assures correct level of care: critical, telemetry, acute, observation, for all admissions. - Work with physicians to assign/order appropriate designation and medical record documentation. - - The incumbent leads the development and manages the implementation of the interdisciplinary plan of care for identified patients, involving all members of the health care team as appropriate. - Functions as an advisor with accountability to escalate cases to medical leadership as necessary to ensure provision of appropriate and effective patient care. -

  • Conducts admission reviews using MCG criteria on all new patients.Assures correct level of care: critical, telemetry, acute, observation, for all admissions. Work with physicians to assign/order appropriate designation and medical record documentation.
  • Consults with and takes referrals from ED physicians, nurses, hospitalists, primary care physicians (PCP), ED patients and families.
  • Consults with admitting office and patient financial services to assist with Medi-Cal and indigent care applications
  • Diverts inappropriate admissions by assisting Emergency Department with complex discharge planning needs of patients.
  • Screen and refer to acute rehabilitation, long-term acute care hospitals, and nursing homes for admission directly from the ED
  • Screen and refer patients for whom treatments could be safely rendered at home with services (e.g., IV antibiotics, low molecular weight heparin injections, wound care, etc.)
  • Consults additional services to complete a safe and effective discharge plan, including physical therapy, social services, palliative care, interpreters, homeless advocates, patient financial services, behavioral health, etc.
  • Assists with patient flow into and through the ED.
  • Identifies high-risk patient through rounding, maintains a list of possible high risk case-types.
  • Develop working relationships with community health resources to improve outpatient access to healthcare for the ED population
  • Develop and maintain community resource information/handouts for ED patients
  • Coordinates family involvement and decision-making as needed
  • Help patients obtain a PCP if needed.
  • Follow up as needed with high-risk patients via phone to ensure establishment with PCP, access, prescriptions, payer sources, self-management, etc.
  • Other duties as assigned.RN License in the State of California required. - Certified Case Manager preferred.The position requires the full understanding and active participation in fulfilling the mission of AHMC- Anaheim Regional Medical Center. - It is expected that the employee demonstrate behavior consistent with the core values. - The employee shall support AHMC- Anaheim Regional Medical Center strategic plan and goals and direction of the performance improvement plan.

Keywords: AHMC Healthcare, Anaheim , Case Manager ED, Executive , Anaheim, California

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