Care Management Leader

2 months ago


Vancouver, British Columbia, Canada Providence Health Care Full time
Job Summary

Providence Health Care is seeking a highly skilled Care Management Leader to join our team. As a key member of our interprofessional team, you will be responsible for leading care coordination and discharge planning for assigned patients.

Key Responsibilities
  • Collaborate with the interprofessional team to determine discharge goals, sub-acute and rehabilitation needs, and appropriate community service availability.
  • Lead daily care rounds and focus team members on developing medical/functional goals as well as a discharge plan for patients that ensures a safe, appropriate, and timely discharge.
  • Assign tasks related to implementation of the discharge plan.
  • Facilitate patient flow activities by identifying patients requiring specialized attention or alternate levels of care in order to move effectively through the system.
  • Act as a resource/advisor for referral to services relative to diagnoses and post-discharge care.
  • Observe, monitor, and evaluate assigned patients' progress, symptoms, and behavioral changes by reviewing patients' daily status.
  • Anticipate patient responses to care, identifies problems or variances from the expected care plan, and intervenes to facilitate resolution of problems and removal of barriers.
  • Reorganize priorities and collaborate with physician and interprofessional team to revise care plans as required to ensure that the plan of care and services provided are patient-focused, high-quality, efficient, and effective.
  • Develop and recommend policies, procedures, and standards to support effective care management and discharge planning.
Requirements
  • Current practicing registration as a Registered Nurse with the British Columbia College of Nurses and Midwives (BCCNM).
  • Three (3) years recent, related experience including (1) year of experience in community care and discharge planning or an equivalent combination of education, training, and experience.
  • Comprehensive knowledge of Nursing theory and practice within a patient/family-centered model of care.
  • Comprehensive knowledge of the BCCNM standards for nursing practice.
  • Broad knowledge of evidence-based nursing practice related to various patient population groups and demonstrated ability to apply knowledge to a case management process.
  • Broad knowledge of pathophysiology and pharmacology, and demonstrated ability to apply knowledge to safely plan discharge.
  • Broad knowledge of biological and pathophysiological indicators related to severity of illness to apply medical appropriateness criteria to resource utilization and transition/discharge planning.
  • Broad knowledge of the illness or disease process and potential long-term complications.
  • Broad knowledge of other health care disciplines and their role in patient care.
  • Broad knowledge of clinical pathways, expected length of stays, resource utilization, and patient assessment.
  • Broad knowledge of external agencies and community resources.
  • Demonstrated ability to engage in comprehensive assessment, observation, and monitoring of patients.
  • Demonstrated ability to plan, organize, and prioritize work.
  • Demonstrated ability to analyze situations, problem solve, deal with conflict, and negotiate resolutions in a timely manner.
  • Demonstrated ability to provide leadership, work direction, and consultation.
  • Demonstrated ability to work independently and as a member of an interprofessional team.
  • Demonstrated ability to develop and maintain collaborative working relationships and communicate (orally and in writing) effectively with clients and their families, coworkers, physicians, other health care staff, and staff of external agencies.
  • Demonstrated computer skills including the ability to effectively use computerized client care information system.
  • Physical ability to carry out the duties of the position.


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