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What's It Like For Case Managers?
Janine C., RN, BSN
View the video.
"There's a lot of responsibility, because of the wide variety of job responsibilities we face daily. People look to us for guidance in all details of care - from admission to discharge. That includes the patients, their families, nurses, staff and the doctors. They want us to solve a lot of problems - and that's why good assessment skills, critical thinking, and a strong knowledge base in Med/Surg are valued and utilized to the full."
The Case Management Department at John Muir Health's Walnut Creek and Concord campuses strives to promote quality, effective interventions and outcomes - and above all else - patient advocacy. The primary functions include Utilization Review and Discharge Planning. Our Case Managers are dedicated to being patient advocates and providing a safe discharge plan.
Utilization Review is the process of collecting and analyzing patient medical information to identify the medical necessity of acute hospital stay, and to make recommendations to lower levels of care. We are in close communication with patients' insurance regarding these two areas. Case Managers also evaluate the cost of care with the benefits of patient safety, quality risk and patient satisfaction to ensure optimal outcomes. They educate patients and families regarding all health care options.
Discharge Planning is the process of providing patients with all necessary information and resources for a safe discharge. This includes the arrangement of home health, vital equipment, transfer to a skilled nursing facility, and community referrals. Case Managers work closely with the multidisciplinary team to determine the discharge plan, and are frequently referred to as the "air traffic controllers" for the hospitalized patient, providing coordinated care throughout the hospitalization and the discharge process.
The traits of a Case Manager are: detail-oriented, autonomous, good communicators, patient advocates, negotiators, educators, decision-makers and efficient facilitators. Ideal candidates are RNs with at least two years of med/surg or critical care bedside nursing experience. Training is provided for new Case Management staff and includes 8 weeks of clinical, one-on-one mentorship and classroom orientation.
If patient advocacy is high on your list of priorities, consider applying to John Muir Health.