Case Manager (PRN)

Essential Functions

• Communicates, collaborates, and coordinates with team members to provide quality patient care and to ensure positive patient outcomes.
• Facilitates communication during interdisciplinary team conference.
• 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 or 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.

Minimum Job Requirements

• Relevant Bachelor’s degree; OR Current state clinical licensure; OR4 years relevant experience required.
• Acute care setting preferred.
• Required Licenses, Certifications, And/or Documentation: Clinical licensure required when required by state.
• Maintains acceptable driving record, current driver’s license, and insurability.

Required Knowledge, Skills, And Abilities

• 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.