Case Manager
The Case Manager works with physicians and multidisciplinary team members to develop a plan of care for assigned patients. Ensures patient is progressing towards desired outcomes by monitoring care through assessments and/or patient records. Identifies and resolves barriers that hinder effective patient care. Actively involved in discharge planning process. This position must integrate company values into daily practice.
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.
- 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.
Minimum Job 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.
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 Over the Course of a Shift
- 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.
- Close vision and the ability to adjust focus.