Per Diem Case Manager RN - Wisconsin (Eden Prairie)

Explore opportunities with Optum , in strategic partnership with ProHealth Care .ProHealth Care is proud to be a leader in health care services, serving Waukesha County and the surrounding areas for more than a century. Explore opportunities across the full spectrum of care as you help us improve the well-being of the community with your skills, compassion and innovation. Be part of a collaborative environment that strives for excellence, nurtures respect and ensures high-quality care delivery to our patients. Join us in making an impact as an Optum Team Member supporting Pro Health Care and discover the meaning behind Caring. Connecting. Growing together .

The Case Manager RN is responsible and accountable for coordination of patient services through an interdisciplinary process, which provides a clinical and psychosocial approach through the continuum of care.Through concurrent case management, patients will be assessed to determine appropriateness of admission, continued hospitalization, as well as appropriate level of care. Case Managers facilitate timely care delivery at the right time, in the right setting, by following CMS guidelines, escalation of operational barriers, and collaboration with all stakeholders. Discharge planning will begin at the time of (or prior to) admission, and reassessed ongoing throughout the course of hospitalization in partnership with the clinical team, the patient, and / or the patient's representative. Quality and Risk Management issues will also be monitored and reported as appropriate.

Locations : You will be asked to support any of the following locations :

Waukesha Memorial Hospital - 725 American Ave, Waukesha, WI

Oconomowoc Memorial Hospital 791 Summit Ave. Oconomowoc WI 53066

Mukwonago Hospital 240 Maple Ave Mukwonago WI 53149

Schedule : As needed / Per Diem, required to work 1 weekend a month

Training : We offer 2 weeks of paid training M-F standard business hours

Primary Responsibilities :

• Takes lead role in directing disposition of patients and utilization considerations
• Assumes leadership role to facilitate interdisciplinary collaboration
• Effectively problem-solves and actively pursues resolution
• Directly communicates with staff, physicians, patients and families
• Role models leadership behavior through courtesy, respect and efficiency
• Coordinates patient care processes to achieve desired quality outcomes and identifies / controls inappropriate resource utilization
• Facilitates patient and family education and promotes continuity of care to achieve optimal patient outcomes. Assures patient rights by offering a choice when appropriate
• Reviews the patient plan of care with the multi-disciplinary team. Facilitates and participates in multi-disciplinary team care conferences for patients with complex problems. Communicates in the medical record and verbally with the team to coordinate interventions and facilitate continuity of care
• Daily communication and collaboration with the patient care staff to provide continuous assessment, evaluation, and continuum planning to assure the patient receives the appropriate level of care at the appropriate time
• Functions without direct supervision, utilizing time constructively and organizing assignments for maximum productivity. Arranges schedules to facilitate meetings with physicians for patient care rounds, team meetings and other opportunities to improve communication
• Ability to effectively read, write, and speak, cognitively process and emotionally support performing other duties as assigned
• Basic Microsoft Office Skills
• All employees are expected to remain flexible to meet the needs of the hospital, which may include floating to other departments to assist as patient needs fluctuate
• Must be able to functionally coordinate and discharge plan for all age groups, including but not limited to the unborn child through geriatric age groups
• The CM will be responsible for integrating the assessment of the need for post-hospital services and determination of an appropriate discharge plan for complex cases
• Educates patient / family as to options / choices within the level of care determined to be appropriate. Initiates and ensures completion of all necessary paperwork
• Facilitates completion of orders as required prior to transfer of patient to the next level of care in a timely manner so discharge is not delayed

Continuum of Care planning will emphasize education and collab