The Case Management department assures several major services to provide 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 each patient 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 on going authorization for continued stay and post hospital needs.  Daily care coordination rounds occur on each nursing unit including ED observation, 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. 

 

RN Case Managers are responsible to be aware of and comply with regulatory requirements of DNV, Medicaid, Medicare and Oregon Nurse Practice Act. 

Case Management is represented on every unit and the Emergency department. 

 

Each Case Manager has an office with a work station near the unit they are assigned to. 

Communication factors: Case Managers are available by pagers 7 days a week during the day. They are also available by telephone/voicemail, Microsoft Teams and e-mail. 

 

Hiring Bonus and Relocation Package Available

 

The OHSU Clinical registered nurse (RN) provides compassionate, evidence-based, and efficient care to individuals, families, communities and patient populations. The Clinical RN's care delivery is consistent with the Oregon Nurse Practice Act, the ANA Scope and Standards of Practice, and the ANA Code of Ethics. The Clinical RN demonstrates the professional role obligations of scientist, leader, and knowledge transferor [Onsomble Model of the Professional Role™]. Professional accountability enriches the Clinical RN's engagement as a leader in promoting an inter-professional culture of collaborative decision-making, innovation, life-long learning, and teamwork. The Clinical RN exemplifies the principles of a Culture of Safety by committing to a Just Culture, a Reporting Culture, a Learning Culture, and an Engaged Informed Culture.

 

This position is specifically for the ED and in addition to the above basic CM functions also provides the following-

• Assuring accurate patient status and admission order for pt's entering via ED, and O.R., 7 days per week.
• Reviews ED Observation unit patients for meeting observation criteria and completes UR  using established criteria.
• Effectively communicates reviews with Patient Placement Office. 
• Performs discharge planning for patients in the Emergency Department. 
• Assesses patients potential to DC from ED with community care coordination (PCP location, follow-up appointments, medication assistance, SNF, LTC, DME, Memory or Foster care)
• Back up for weekend/EVE Case Managers.
• Reviews transfer center patients and advise physicians on acceptance of potential transfers. 
• Educates providers regarding documentation requirements that support medical necessity determinations. 
• Delivers Condition Code 44 notices, Observation notices, and Medicare Important Messages in the absence of sufficient clerical support. 
• Leads the effort to assure compliance with CMS and other insurance regulations related to Utilization Review.  

• Current, unencumbered Oregon RN license 
• Associate or Baccalaureate Degree in Nursing from a program accredited by Commission of Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN) or Commission for Nursing Education Accreditation (CNEA)
• BSN preferred
• Associate Degree Nurses required to enroll in BSN program within 3 years of hire and complete within 5 years of hire.
• 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 Management Certification (ACMA, RN-BC, CMSA)
• Hospital based case management experience
   

Usual Orientation Time:    
Experienced hospital based Nurse Case Manager                4-6 weeks        
Experience in acute care but not Case Management            4-6  weeks        
Resource                                                                         4-6 weeks 
 

 

Working conditions:

• Ability to lift, bend, stoop, reach, carry, push, pull and walk throughout the work period.
• Complies with the safe patient mobilization policy when lifting or positioning dependent patients, including using mechanical lifts and coordinating the assistance of other personnel.    
• Must be able to use all senses: seeing, hearing, touching, smelling, and speaking.  Reasonable accommodations include  corrective lenses and/or hearing aids
• The work environment carries risk of exposure to human tissue/fluids and radiation. 
• Must be able to deal with competing needs and priorities of internal and external customers, including making correct judgments regarding ensuring safe conditions for patients, families, and other personnel.  
• Use of relevant hospital approved clinical equipment.  
• Significant use of computers, copiers, multi-line phones, and fax.  
  
  *Bonus Disclaimer: current RN employees at OHSU, Adventist Medical Center in Portland or Hillsboro Medical Center are not eligible for the hiring bonus. 

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Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.


As an organization devoted to the health and well-being of people in Oregon and beyond, OHSU requires its employees to be fully vaccinated against COVID-19.