Case Manager Care Coordination

This position provides comprehensive care coordination for patients as assigned. The intensity of care coordination provided is situational and appropriate based on patient need and payer requirements. This position is accountable for the clinical quality of Care Coordination services delivered by both them and others and identifies/resolves barriers which may hinder effective patient care. The goal is to empower the patient and the family to participate to the fullest of their abilities in the discharge planning process. Case Managers cover units throughout the hospital and generally work in multiple areas each day. Schedule: Monday - Friday 7am - 4:30pm. Weekend rotations every 3 weeks. Holidays are rotated on the team.

Responsibilities

Provide comprehensive care coordination for patients as assigned; Manage individual patients across the health care continuum to achieve optimal clinical care, financial, operational, and satisfaction outcomes; Lead process improvement activities for patient populations; Lead the development and management of the interdisciplinary patient discharge plan and communicate it across the continuum of care; Conduct initial assessments on patients; Participate in daily multi-disciplinary rounds; Communicate discharge plan and updates to patients, families, and the medical team; Delegate tasks to a transitional care associate; Maintain knowledge of Medicare, Medicaid, and other program benefits and community resources; Establish and promote collaborative relationships with physicians, payers, and the health care team; Collect and communicate information to payers to fulfill utilization and regulatory requirements; Educate internal team members on case management and managed care concepts; May supervise other staff

Requirements

Current Registered Nurse (R.N.) license in state worked, or Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW), or equivalent license with a Master's Degree in Social Work (MSW) and licensure required within 6 months of hire date; Knowledge of case management or utilization review, normally obtained through a bachelor's degree in case management or health care (RN); Basic Life Support (BLS) certification for acute care assignments; Proficiency typically achieved with 2 years of clinical experience; Critical thinking skills; Problem-solving abilities; Effective communication skills; Time management skills; Ability to work effectively in an interdisciplinary team format; May have to take rotating call based on acute facility need; For Case Management positions in acute facilities, Banner Registry and Travel positions require a minimum of one year Case Manager experience in an acute care hospital

Nice to have

Certification for CCM (Certified Case Manager); Additional related education and/or experience