Case Manager is responsible for chart review to evaluate medical necessity for admission, continued stay, and the appropriate level of care. Monitors the care of assigned patients to assure quality cost effective utilization of resources and optimal outcomes. Responsible for coordinating the patient's plan of care from admission to discharge and or transfer to another level of care.
ResponsibilitiesPRINCIPAL DUTIES AND RESPONSIBILITIES(*Essential Functions)
JOB SPECIFICATIONS(Minimum Requirements)KNOWLEDGE, SKILLS, AND ABILITIES
- Knowledge of appropriate and timely return transition levels of care.
- Knowledge of CARF, Regulatory Agencies and State Board of Health, Long Term Care, Acute Care and Ambulatory Care Standards.
- Demonstrates excellent interpersonal and problem-solving skills.
- Demonstrates self-directed, goal orientated and customer service.
- Excellent organizational and prioritization skills to meet deadlines.
- Capable of functioning effectively across service lines.
- Ability to assess and interpret data about the patient's status in order to identify each patients age, specific needs and provide the care needed by the infant, child, adolescent, young adult, middle adult and geriatric patient.
- Ability to independently perform comprehensive chart review with subsequent abstraction or relevant information including interpretation of lab results, EKG and other medical tests.
- Ability to communicate effectively both verbally and in writing.
- Ability to provide compassionate patient care orientated with an effort for timeliness and accuracy in the delivery of service.
- Ability to respond positively to the needs of patients and family.
- Addresses customer concerns in a private, respectful and calm manner.
EDUCATION
- Bachelors Nursing Required
- 3 Required RN Case Manager Expereince
- Licensed Registered Nurse
- Certified Cardiac Pulmonary Resuscitation
STANDARDS OF BEHAVIORMeets the Standards of Behavior as outlined in Personnel Policy and Procedure #1, Employee Relations Code.CONFIDENTIALITY/HIPAA/CORPORATE COMPLIANCEDemonstrates knowledge of procedures for protecting and maintaining security, confidentiality and integrity of employee, patient, family, organizational and other medical information. Understands and supports the commitment of Methodist Hospitals in adhering to federal, state and local laws, rules and regulations governing ethical business practices for healthcare providers.DISCLAIMER - The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. The statements are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required.
Skills Required
- Bachelor's degree in Nursing
- Registered Nurse license
- Three years of RN case management experience
- Certified Cardiac Pulmonary Resuscitation
What We Do
Methodist Hospitals is a nonprofit healthcare organization serving Northwest Indiana. Its mission is to provide compassionate, quality health care to all those in need. The organization operates three campuses with 562 inpatient beds and employs 2,412 people, including 590 physicians and allied health professionals. It provides hospital and medical services while emphasizing patient care, physician practice, employee experience, and community health.
