Full-Time Quality Case Manager at Russellville Hospital Position Summary Maintains an effective, planned, systematic, concurrent review and evaluation process of the medical necessity, quality, appropriateness, timeliness, and utilization of hospital care/services provided in accordance with established indicators/criteria, hospital policy and CMS CoP requirements. Participates in the development and implementation of the Quality/Resource Management Program and Swing Bed Program. Collaborates effectively with interdisciplinary healthcare team to ensure seamless patient care and optimal outcomes. Responsibilities Accurately abstracts records for eCQM &Core Measures and submits via authorized vendor in timely fashion to meet deadlines. Understands value of accuracy and discusses any discrepancies or questions with Quality Resource Management Director prior to data submission. Concurrently reviews electronic documentation for eCQM compliance demonstrating knowledge and leadership in electronic clinical quality measures. Complete ongoing assessments and update the Plan of Care as appropriate. Active member of the hospital care team concurrently promoting high level quality care recognizing our goal is zero harm to patient. Record evaluations of nursing interventions, including patient responses. Maintains knowledge of current accreditation standards and quality measure specifications as well as best practices in regard to quality reporting, clinical outcomes, and performance improvement activities. Demonstrate the knowledge and skills necessary to care for patients of all ages, verified by unit skills competency checklists. Attends webcasts and workshops related to Inpatient/Outpatient Quality Program as well as all other value-based quality programs. Adhere to allotted breaks and meal times. Perform patient care and treatments with consideration for: Cultural diversity. Age-specific patient population served. Established policies and procedures. Demonstrates culturally sensitive care by effectively utilizing Language Line to communicate clearly with patients who have chosen preferred language other than English to ensure accurate information exchange and patient understanding. Complete other duties assigned by Nursing or Hospital Administration. Recognize and address the psychosocial and spiritual needs of patients, families, and significant others. Follow established infection control and standard precaution policies and procedures. As needed, be accountable for physician orders. Requirements Valid nursing license (RN) with current registration in the applicable state or region. One to three years of RN work experience preferred. Proven experience in critical care settings such as ICU, Level I or Level II trauma centers, or emergency medicine environments. Knowledge of health regulation policies including HIPAA compliance and medical terminology for accurate documentation and patient communication. Demonstrated ability to perform thorough patient assessments and manage complex clinical cases involving physiology knowledge and diagnostic evaluation. Proficiency in EMR/EHR systems for efficient electronic health records management; familiarity with discharge planning and post-acute care coordination is preferred. Excellent client communication skills with the ability to collaborate effectively with multidisciplinary teams to deliver outstanding patient service. Join us as a Quality Case Manager to make a meaningful difference in patients' lives by providing expert clinical guidance and compassionate support throughout their healthcare journey!

Benefits:

401(k) 401(k) matching Dental insurance Employee discount Health insurance Paid time off

Work Location:

In person