Case Manager - PRN

About the role

The Case Manager works with physicians and multidisciplinary team members to develop a plan of care for assigned patients. They ensure the patient is progressing towards desired outcomes by monitoring care through assessments and/or patient records. They identify and resolve barriers that hinder effective patient care and actively participate in the discharge planning process.

Responsibilities

• Communicates, collaborates, and coordinates with team members to provide quality patient care and ensure positive patient outcomes.
• Facilitates communication during interdisciplinary team conferences.
• Responsible for accreditation standards and adheres to all standards set forth by the State and accrediting agencies of TJC and CMS.
• Documents communication and coordination of patient activities, medical necessity, and post-discharge equipment and support needs in the health care record.
• Supports and facilitates length of stay management.
• Conducts utilization reviews.
• Communicates appropriate information for timely updates and authorizations with payors.
• Ensures the outcome of this information is timely communicated to clinical team and administration.
• May be required to work during inclement weather and other staffing emergencies.
• Provides an environment conducive to safety for patients, visitors, and staff.
• Assesses the risks for safety and implements appropriate precautions.
• Complies with appropriate and approved safety and Infection Prevention standards.
• Performs other duties as assigned to support overall effectiveness of the organization.

Requirements

• Minimum Education & Experience: Two years’ recent relevant experience required. Acute care setting preferred. Bachelor’s degree preferred.
• Required Licenses, Certifications, And/or Documentation: Current state clinical licensure required.
• Must maintain acceptable driving record, current driver’s license, and insurability.

Qualifications

• Demonstrates an understanding of treatment costs and financial support as they relate to quality and efficiency.
• Demonstrates critical thinking skills: Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
• Knowledge of community resources to meet post-discharge clinical and social needs.
• Knowledge of clinical operations and procedures.
• Ability to establish and maintain pro-active relationships with internal interdisciplinary team members, insurance companies, physicians, referral sources, community service organizations and health care facilities.
• Ability to maintain quality, safety, and/or infection prevention standards.
• Demonstrates general computer skills including data entry, word processing, email, and record management.
• Effective organizational and time management skills.
• Effective written and verbal communication skills.
• Ability to maintain proper levels of confidentiality.
• Ability to work closely and professionally with others at all levels of the organization.

Physical Requirements

• A significant amount of standing and walking.
• Lifting/exerting of up to 25 lbs.
• Possible exposure to bodily fluids.
• Visual acuity required for patient assessment and documentation.
• Acute hearing required for accurate patient assessment.
• Sufficient manual dexterity to operate equipment and computer keyboard.
• Closed vision and the ability to adjust focus.