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.
• Completes required trainings, as assigned.
• Performs other duties as assigned to support overall effectiveness of the organization.

Minimum Job Requirements 

Minimum Education & Experience 

• Relevant Bachelor’s degree; OR
• Current state clinical licensure; OR
• 4 years relevant experience required.
• Acute care setting preferred.
   

Required Licenses, Certifications, and/or Documentation

• Clinical licensure required when required by state.
• 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