Description
Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?
Summary:
- Monitors appropriate use of internal resources, communication with interdisciplinary care team and Physician Advisor, with timely coordination of home care, DME, placements, hospice, community resources, transportation, and quality data collection and risk management referral.
Responsibilities:
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Utilization management activities: monitor appropriate use of internal resources, communication with interdisciplinary care team and Physician Advisor
Discharge planning activities: timely coordination of home care, DME, placements, hospice, community resources, transportation
Quality data collection and risk management referral
Works with patient and family to assure provision of choice in post hospital setting
Educates patient / customers regarding scope and limitations of health care / insurance benefits
Respects each patient’s / customer’s personal dignity, right to privacy and confidentiality
Communicates expected discharge time frame
Keeps current with new providers, new technologies and treatment modalities, and new resources using internet and other sources
Recognizes and provides care based on the unique chronological issues and needs of the older adult.
Interacts with the patient and family in a developmentally appropriate manner.
Discharge Planning:
Completes timely and detailed assessment of patient and family social, emotional and/or discharge needs and health care benefits
Develops and facilitates specific plan to address problems and/or concerns identified by patients, families and health care team
Identifies and consistently documents delays; elevates issues appropriately
Effectively communicates discharge plan with patients, families and health care team
Documents ongoing assessments and plan of care in patient record (Canopy)
Successfully assists patient in moving to the next level of care with transfers to home, agencies, and facilities and with referral to appropriate community resources
Participates and drives accountability in daily interdisciplinary meetings
Utilization Management:
Adheres to guidelines to satisfy 3rd party payer requirements
Educates team in appropriate documentation to reflect Intensity of service (IS) / Severity of Illness (SI) and plan of care
Proactively addresses level of care issues to ensure appropriate care settings and timely patient flow; elevates issues appropriately
Enters all review activity in Canopy concurrently
Accounts for all patient days accurately in Canopy
Enters review indicating “pending” status of case if outcome not determined and accounts for all cases assigned on a daily basis
Collects and submits data as indicated
Completes readmission screen as indicated
Quality Improvement and Risk Management:
Collects and submits data as indicated
Communicates with service line / clinical effectiveness team members
Identifies and appropriately communicates risk management issues
Works with department leadership to develop and implement solutions to issues identified by the Case Management and Social Work Department
New Technology / Computer Systems:
Keeps current with new systems (MedView, On Base, SafetyNet, Sunrise, etc.)
Incorporates technology into daily assignment (Outlook, Canopy, CERME, ECIN, shared drive, Internet)
Credentials:
- Registered Nurse - PA (Required)
- PA RN Licensure required.
Education or Equivalent Experience:
- Bachelor of Arts or Science (Required)
- Bachelor's Degree in Nursing required.2+ years Clinical Experience preferred.
Live Your Life's Work
We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.
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