The Care Management department provides several major services to assure a safe and efficient passage of patients through their acute hospitalization and transition to the next level of care. Our goal is to balance individual clinical and psychosocial patient/family needs with the efficient and cost effective utilization of resources while promoting quality outcomes.
RN Case Managers provide a coordinated approach with in the interdisciplinary team in determining appropriateness of admission, continued stay in the hospital and planning for transition to various levels of care in the hospital, community and home. Intensity of service is dependent on individual patient needs as assessed by the case manager. Nurse Case Managers assure robust utilization review, resource management and discharge planning.
RN Care Managers assess patients on admission for available family support, insurance resources, and potential discharge planning needs. They use established criteria to determine appropriateness of admission and continuing stay and work with insurance companies to assure ongoing authorization for continued stay and post hospital needs. Daily care coordination rounds occur on each nursing unit Monday through Friday at which Case Managers meet various disciplines to discuss the plan for the day and the plan for the patients stay. They will also frequently lead and/or be involved in multidisciplinary care conferences with family involving complicated care situations. They contribute to meeting OHSUs strategic plan of safe LOS reduction and reduction in readmission rates.
RN Case Managers are responsible to be aware of and comply with regulatory requirements of JACHO, Medicaid, Medicare and Oregon Nurse Practice Act.
Current, unencumbered Oregon RN license
Bachelors degree in Nursing for external hires; BSN preferred for internal candidates
Proficiency within the interdisciplinary team in leading daily discharge rounds, negotiating conflicts, coordinating patient goals between disciplines, communicating about and educating physicians on patient status decisions.
Ability to describe what utilization review criteria is and how it is utilized.
Proficiency with managing difficult and sensitive family and provider care conferences including: adjustment to new levels of function, end of life discussions, imbalance of available resources (social, spiritual, medical, financial).
Progressive leadership positions with in nursing unit examples include: Charge nurse, UBNPC Chair/Member, Shared Governance councils.
Case Managers are available by pagers 7 days a week during the day. They are also available by telephone/voicemail and e-mail.
Case Management Certification (ACMA, RN-BC, CMSA, CCM)
As the state's only health and research university, OHSU brings together patient care, research, education of the next generation of health care providers and scientists and community service to improve the health and well-being of all Oregonians.The university is a conduit for learning for more than 2,800 students, providing training to interns, residents and fellows in postgraduate medical and r...esearch. It is the only place in Oregon that grants doctoral degrees in medicine, dentistry and nursing. OHSU cares for more than 251,000 patients each year from around the region and takes a leadership role in contributing to solutions involving the health of the state and the nation, such as health care access and transparency, ethics and workforce shortage. Beyond providing critical health care services, quality education and cutting-edge research, OHSU also is a key economic and social force in the Northwest. With an annual operating budget of $2.06 billion and more than 14,000 employees, OHSU is Portland?s largest employer. Its size contributes to its ability to provide many services and community support activities not found anywhere else in Oregon. For more information visit http://www.ohsu.edu/xd/about/index.cfm