Case Manager Care Coordination

About the role

As the Case Manager in Care Coordination, you will provide comprehensive care coordination for patients as assigned. This position is accountable for the clinical quality of Care Coordination services delivered by both you and others and identifies/resolves barriers which may hinder effective patient care. Case Managers cover units throughout the hospital and generally work in multiple areas each day.

Responsibilities

• Conduct initial assessments on patients
• Participate in daily multi-disciplinary rounds
• Communicate the discharge plan and updates to patients, families, and the medical team
• Delegate tasks to a transitional care associate
• Manage individual patients across the health care continuum to achieve optimal clinical care, financial, operational, and satisfaction outcomes
• Act in a leadership function with process improvement activities for populations of patients
• Collaboratively develop and manage the interdisciplinary patient discharge plan
• Effectively communicate the plan across the continuum of care
• Maintain knowledge of Medicare, Medicaid and other program benefits to assist patients with discharge planning and choices
• Establish and promote a collaborative relationship with physicians, payers, and other members of the health care team
• Collect and communicate pertinent, timely information to payers and others to fulfill utilization and regulatory requirements
• Educate internal members of the health care team on case management and managed care concepts
• Facilitate integration of concepts into daily practice
• May supervise other staff

Requirements

• RN: Must possess knowledge of case management or utilization review as normally obtained through the completion of a bachelor's degree in case management or health care. Requires current Registered Nurse (R.N.) license in state worked.
• Social Worker: Requires a Master's Degree in Social Work. Requires a Licensed Master Social Worker (LMSW) (equivalent*) or Licensed Clinical Social Worker (LCSW) or have a MSW with the requirement to become licensed within 6 months of hire date. An equivalent license applies to states that do not recognize an LMSW; therefore, the employee must possess a Master’s Degree and be a Licensed Social Worker.
• For assignments in an acute care setting, Basic Life Support (BLS) certification is also required.
• Requires a proficiency level typically achieved with 2 years clinical experience.
• Must demonstrate critical thinking skills, problem-solving abilities, effective communication skills, and time management skills.
• Must demonstrate ability to work effectively in an interdisciplinary team format.
• May have to take rotating call based on the acute facility need.
• For Case Management positions in acute facilities, Banner Registry and Travel positions require a minimum of one year Case Manager experience in an acute care hospital.

Preferred Qualifications

• Certification for CCM (Certified Case Manager) preferred.
• Additional Related Education And/or Experience Preferred.