Patient Care Manager - MSW

Patient Care Manager

The Patient Care Manager facilitates progression-of-care; monitors the patient's progress to ensure the plan of care and services provided are patient focused, high quality, evidence based, appropriate to patient needs, efficient, and cost effective.

• Has basic understanding of Relationship-Based Care (RBC) principles, meets expectations outlined in Commitment To My Co-workers, and supports RBC unit action plans.
• Uses effective customer service/interpersonal skills at all times.
• Maintains working knowledge/experience in utilization management, managed care, and payer issues that may impact the course of care.
• Timely response to screening referrals for case management services.
• Identifies appropriate community resources on assigned caseload and works collaboratively with patients, families, and multidisciplinary team and community agencies to achieve desired patient outcomes.
• Educates members of the patient's healthcare team on the appropriate access to, and use of various levels of care.
• Identifies patients at risk for readmission and refers them for community based follow up.
• Consults with physician advisor as necessary to resolve progression-of-care barriers through appropriate administrative and medical channels.
• Serves as primary liaison between and among physicians, patients, families, payers, external case managers and interdisciplinary clinical team.
• Participates in discharge planning activities for complex patients, ensuring a timely discharge and appropriate linkage with post-discharge care providers.
• Collaborates with Post-Acute Coordinators to monitor and facilitate the progress of completing complex post-acute services.
• Interface with utilization review specialists to stay current on patient's eligibility for admission, continuing stay or readiness for discharge according to medical necessity guidelines (InterQual criteria).
• Persevere in attempts to influence clinical and financial outcomes of care.
• Identify and record episodes of preventable delays or avoidable days due to failure of progression-of-care processes.
• Participates in quality improvement plan activities and any other departmental research or studies as requested by the department manager.
• Assertively manage resource utilization while appropriately navigating the patient's movement along the continuum of care.
• Collaborate with social workers, counselors and Resource Center coordinators to research discharge placement options, focusing on patient/family goals, interdisciplinary team recommendations, available payer benefits and private financial considerations which may impact placement.
• Utilizes the Program Manager, Director and Medical Advisor as expert advisors to gain insights in dealing with physicians and Resource Management issues.
• Works with resource center and providers to determine patient's eligibility for post-acute services.
• May assist in training and orientation of new department employees and students.

What’s Required

• Bachelor's Degree in Nursing or Social Work. Comparable experience will be considered in lieu of a Bachelor's degree in nursing (must have RN license or social work license).
• Must have recent hospital patient care experience (minimum 3 years) and knowledge of hospital operations.
• Must have Master Social Work license.

Additional Information

• This position requires a Master Social Work license in the state of Michigan.
• Munson Healthcare requires all employees be vaccinated or have lab confirmed immunity for Measles, Mumps, Rubella and Varicella.
• MHC also requires all employees to receive a flu vaccine during the flu season in the year they are hired and annually thereafter, or receive an approved medical or religious exemption.