Overview The Case Manager oversees the process of care delivered to patients, works collaboratively, and provides leadership to the healthcare team, and is committed to organization goals. This includes observation level of care vs inpatient level of care based on medical necessity and patient discharge planning. The role also focuses on minimizing barriers to discharge and ensuring appropriate level of care and reimbursement through assessment and coordination.
Responsibilities Coordinates/facilitates patient care progression throughout the continuum of care.
Assures the plan of care and services provided are patient focused, high quality, efficient and cost effective.
Meets directly with patient/family to assess needs and develop an individualized continuing care plan in collaboration with the physician.
Monitors length of stay and ancillary resource use on an ongoing basis and takes actions to achieve continuous improvement in both areas.
Communicates information to the Utilization Management or Case Management team to aid in appropriate level of care determination and reimbursement by third party payors as well as working closely with the Physician Advisory team on concurrent denials to ensure the most appropriate level of care prior to billing.
Monitors patient flow through multidisciplinary rounds and aids in implementation of processes for improvement to decrease delays.
Serves as patient advocate to ED population by identifying needs, coordinating services and resources for the management of complex patients to facilitate quality care and cost efficient outcomes.
Ensures that all elements critical to the plan of care have been communicated to the patient/family as well as members of the healthcare team.
Ability to cover various populations across the organization, including the Emergency Department.
Performs all other duties as requested by Case Manager Supervisor and/or Director.
Qualifications 1-2 years of recent acute care hospital experience required.
Data entry/computer experience required.
RN license required
About Us Founded in 1906, McLeod Health is a locally owned and managed, not-for-profit organization supported by more than 900 medical staff members and more than 2,900 licensed nurses. McLeod Health comprises approximately 15,000 team members and more than 90 physician practices throughout its 18-county service area. The system operates seven hospitals and provides additional services including Health and Fitness Centers, a Sports Medicine and Outpatient Rehabilitation Center, Hospice and Home Health Services. The hospitals within McLeod Health include: McLeod Regional Medical Center, McLeod Health Dillon, McLeod Health Loris, McLeod Health Seacoast, McLeod Health Cheraw, McLeod Health Clarendon and McLeod Behavioral Health.
About The Team If you would enjoy working in a dynamic environment and are looking for an opportunity to become part of a stellar team of professionals, we invite you to apply online today. We are an equal opportunity employer.
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