This position provides case management for patients with end stage organ disease referred for transplantation. This position facilitates pre- and post-transplant care for patients through face to face or telephonic interventions, providing, facilitating, and coordinating support for transplant program initiatives, as well as education and training for both patients and providers. The position is responsible for managing outside medical costs and effectively utilizing internal resources including but not limited to DME, outpatient infusion, home health.

This position is responsible for collaborating closely with the multidisciplinary team to develop and implement an up-to-date plan of care.

The incumbent will communicate with the team on behalf of the patient. Using clinical protocols this nurse facilitates patient referral to appropriate specialists for diagnosis or treatment and provides support and counseling to the patient and their family, as appropriate to the clinical situation.

This position assists with the coordination and development of evidence-based protocols and may accomplish this work through leadership of committees of multidisciplinary professionals.

The incumbent will proactively develop and enhance processes with the goal of improving the clinical experience for referred patients and the referring physician. In collaboration with the department's leadership and/or Medical Directors, referring physicians and interdisciplinary team(s), this individual assists with coordination of multidisciplinary conferences and provides care as needed for patients and their families utilizing resources efficiently and effectively.

The incumbent assists in the development and performance of specialty service educational activities and program evaluation. The incumbent works with marketing and outreach departments to educate referring physician offices and facilities on available services.

This position assists in meeting the needs of the hospital's community in relation to education, screening, prevention, and treatment. Most important, this position improves the care experience of the patient and their family.

Provides and coordinates the multidisciplinary clinical care of potential and actual transplant candidates and recipients. Coordinates the clinical management of post-transplant patients. Manages data for transplant patients. Plans, develops, implements, and evaluates educational programs and publications designed to meet the needs of nurses, medical personnel, patients, families, and the community.

Coordinates case management to include, but not limited to, continuity of care, inpatient and outpatient care, utilization management, transfer coordination, discharge planning, travel and lodging needs, patient, and family education specific to transplant related care and in-patient concurrent review.

Facilitates an effective and efficient case management process that integrates a multitude of services together to ensure that a comprehensive system for care is in place, where patients are appropriately managed through the continuum of care, resources both internally and externally are appropriately utilized, and successful outcomes are achieved.

Utilizes the nursing process to identify barriers to care and select appropriate solutions from potential options for intervention, based on a set of complex and individual patient needs. This includes identifying cultural and linguistic needs and incorporating actions to address such needs in the case management plan

This position does provide patient care.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Name

Description

Education:

Must have working-level knowledge of the English language, including reading, writing and speaking English. Bachelor's degree in nursing preferred.

Experience:

Minimum three years' experience in clinical transplant services or case management (disease management, population management, chronic disease management, complex case management)

License(s):

Ability to obtain and maintain a State of Nevada Registered Nurse license.

Certification(s):

Current BLS by AHA standards required.

Certification in clinical transplant coordination (CCTC, ITNS) or case management (CCM) preferred.

Computer / Typing:

Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.