Case Manager
4 weeks ago
The Case Manager is responsible for the interdisciplinary coordination of care for a designated patient population. The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level team to facilitate achievement of desired financial and quality outcomes. The Case Manager will also maintain and enhance payor relationships. Performs other related duties as assigned or requested. This is an exempt position.
RESPONSIBILITIES
Admission Data Collection and Assessment
• Assesses, plans, monitors, and coordinates plan of care from pre-admission to community re-entry through the implementation of case management standards and processes.
• Assesses the individual’s personal and medical history, current status, diagnosis, prognosis, and the proposed treatment plan.
• Promotes and utilizes the appropriate level of care for the patient and refers to other facilities as needed.
• Adheres to contract agreements and specific criteria.
• Serves as a liaison with payor source points of contact to verify and guarantee coverage and identify items required to process the claim for service.
• Assists patient and or caregiver in developing realistic goals to direct the treatment regimen.
• Proactively communicates with payor source to explore coverage solutions (flex benefits, out of contract, etc.).
Planning, Implementation & Facilitation
• Promotes optimal outcomes for the patient within the boundaries of the diagnosis.
• Coordinates and facilitates interdisciplinary team (IDT) meetings and plan of treatment.
• Meets with patient, family, and IDT to facilitate “continuity of care”.
• Implements utilization review process and continuously evaluates the appropriate level of care with the interdisciplinary team and payor, and patient/caregiver(s). Proactively obtains authorization for any extension of service of LOS.
• Coordinates the discharge plan with the IDT and providers.
• Monitors expense versus revenue for caseload on a daily basis.
Advocacy
• Proactively collaborates with the health care team, payors, community agencies, providers and legal representatives to ensure continuity throughout the continuum.
• Serves as a liaison with the treatment team and the primary care physician, referring physician, medical director, patient/caregiver(s), and other parties as appropriate.
• Promotes effective communications among treatment team members, patient/caregiver(s), primary care physician, referring physician, medical director, and payor.
• Participates in care conferences, family conferences, etc. when indicated.
• Educates and supports the individual/family to be empowered and self-reliant in being advocates for themselves.
• Uses the mechanism of early referral to promote and provide optimum care and cost containment.
• Represents the individual’s best interests through assisting in finding necessary funding, offering treatment alternatives, and coordinating treatment.
Monitoring & Evaluation
• Continuously reviews and evaluates the patient’s progress, as reflected by the goals defined in the treatment plan.
• Uses appropriate auditing processes and tools to ensure department and treatment efficiency.
• Participates in performance improvement evaluation processes with particular emphasis on results-oriented treatment.
Professional Growth
• Maintains professional growth in case management by: attending continuing education opportunities; reviewing pertinent professional literature; maintaining knowledge of current community resources; and reviewing and being familiar with the managed care marketplace to determine managed care growth potential, opportunities, penetration, service trends, relationships, networks, etc.
QUALIFICATIONS
Education and Training: RN licensure in state where the hospital resides required. Current BLS certification required.
Experience: Three to five years of inpatient experience, preferably in an acute, IRF or LTACH setting.
PAM Health does not discriminate and does not permit discrimination, including, without limitation, bullying, abuse or harassment, on the basis of actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status, or based on association with another person on account of that person's actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status.
-
Social Services Case Manager
3 weeks ago
Overland Park, United States Kansas City International Full timeCancer Action, Inc Overland Park, KS Full-time Social Service Posted on April 12, 2024 Cancer Action is seeking to hire a compassionate professional to be a Case Manager. Cancer Action is a local nonprofit providing practical and financial services and emotional support to cancer patients and their families living in the Kansas City metro area. Case Managers...
-
Case Manager
4 weeks ago
Overland Park, United States PAM Health Full timeJob DescriptionJob DescriptionCase Manager (RN)The Case Manager is responsible for the interdisciplinary coordination of care for a designated patient population. The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level team to facilitate...
-
Case Management
4 days ago
Newbury Park, United States Dale Workforce Solutions Full timeTitle (Role) Case Management - ManagerOrganization Global Patient SafetyLocation: Remote•Act as US/EU local safety office and FDA/EMA point of contact for safety reporting•Submission of all individual case safety reports to FDA/EMA, business partners (license partners) and vendors•Support interactions with, business partners (license partners) and...
-
Case Manager
4 weeks ago
Manassas Park, United States Bull Run Alcohol Safety Action Prog Full timeJob DescriptionJob DescriptionThis position will be responsible for the screening, management, monitoring and supervision of program participants. The position will also prepare court reports and other documents related to monitoring participants and will testify in court hearings. The case manager will be responsible for evaluating all aspects of program...
-
Case Manager
5 days ago
Manassas Park, United States Bull Run Alcohol Safety Action Prog Full timeJob Description Job Description This position will be responsible for the screening, management, monitoring and supervision of program participants. The position will also prepare court reports and other documents related to monitoring participants and will testify in court hearings. The case manager will be responsible for evaluating all aspects of program...
-
Case Manager
4 weeks ago
Woodland Park, United States Resources for Human Development Full time $22Do you enjoy making a positive impact in the community?RHD's SALT Passaic is looking for a Full-time Case Manager to join our Team!The case manager will determine the resources needed to meet the individualized needs of the participant. The case manager will take all necessary actions in assuring the implementation of the service treatment plan including...
-
RN Hospice Case Manager
3 days ago
Overland Park, KS, United States Phoenix Home Care and Hospice Full timeSeeking a Hospice Registered Nurse Case Manager in the Overland Park, KS and surrounding areas.Phoenix Hospice RN Case Managers provide compassionate nursing care to clients and their families dealing with a terminal diagnosis. RN Case Managers work with the interdisciplinary team to develop and implement a plan of care that is patient/family centered, with...
-
Manager Case Management
5 days ago
Orange Park, United States Becker Health Full timeManager of Case ManagementHCA Florida Orange Park HospitalFull Time - Days 7-10 Hrs/Weekdays Only Orange Park Medical Center is a full service, certified Level II Trauma Center with 300 plus inpatient beds located in the heart of Orange Park, FL and just outside of Jacksonville, FL. This state-of-the-art facility provides top-notch medical care to Clay...
-
Case Manager
1 week ago
Walnut Park, United States InsideHigherEd Full timeJob no: 494417Work type: RegularLocation: HybridCategories: SalariedTitle: Case ManagerDepartment: Dean of Faculty's OfficeDuration: 12 months Job SummaryIn compliance with the Americans with Disabilities act as amended in 2008, Section 504 of the rehabilitation act of 1973 and the Fair Housing Act, the Case Manager coordinates student accommodations and...
-
Paralegal Case Manager
6 days ago
Highland Park, United States Kass and Moses, PC Full timeJob DescriptionJob DescriptionPosition: Associate Case Manager Location: Northbrook, Ilinois Salary: $40,000 annually Benefits:Contribution towards health insurance; 401(k) plan Job Overview:We are seeking a motivated and detail-oriented Associate Case Manager to join our team. The ideal candidate is a fast learner, excellent problem solver, and strives...
-
Account Manager- Life and Annuities
12 hours ago
Overland Park, United States Lockton, Inc. Full timeJob Summary: SUMMARY: Lockton Affinity, located in Overland Park, KS, is looking for an Account Manager to join the Synchronize team. The Account Manager will own, manage, and provide customer support with caseload of in-process life insurance, annuity, long term care or related applications from submission to policy issue. ESSENTIAL DUTIES AND...
-
Case Manager, Juvenile Justice
3 days ago
Allen Park, United States The Guidance Center Full timeJob Type Full-timeDescriptionAs a recognized leader in our field, The Guidance Center provides a broad range of services that have helped children, adults and families unlock potential and build better lives since 1958. With 25 programs we offer treatment, prevention, growth and education services to more than 15,000people annually. Together we: Nurture...
-
Case Manager
1 month ago
Highland Park, United States RCHP-AHC Reformed Church of Highland Park Affordable Housing Corp. Full time**Job Description** -** I-RISE Case Manager - **Interfaith-RISE - Reformed Church of Highland Park Affordable Housing Corporation **Position Description** This position will be located in both the Highland Park and Neptune (Monmouth County) satellite office. The Case Manager provides case management to refugee families, inclusive of pre-arrival planning...
-
Resource Navigator/case Manager
1 month ago
Asbury Park, United States Community Affairs and Resource Center Full time**Job Position**: Resource Navigator/Case Manager **Title**: Resource Navigator/ Comprehensive Eviction Defense and Diversion (CEDD) **Reports Directly To**: Program Director **Job Summary**: To provide social services support, case management and immediate problem-solving intervention including flexible direct client financial assistance and linkages to...
-
RN Case Manager
2 weeks ago
Orland Park, United States Dupage Medical Group Full timeRN Case Manager - Care AllyOverview * Full-Time, 40 hours per week. Monday through Friday, 8:00 a.m. to 5:00 p.m.; flexibility to work later as needed * Location: Orland Park Good enough isn't for us. Duly Health and Care's team members show up every day driven to exceed expectations. We see and support the remarkable in every person within and beyond the...
-
RN Case Manager
2 weeks ago
Tinley Park, United States Dupage Medical Group Full timeRN Case Manager - Care AllyOverview * Full-Time, 40 hours per week. Monday through Friday, 8:00 a.m. to 5:00 p.m.; flexibility to work later as needed * Location: Tinley Park Good enough isn't for us. Duly Health and Care's team members show up every day driven to exceed expectations. We see and support the remarkable in every person within and beyond the...
-
Case Manager II
3 days ago
Avon Park, United States tri county human services Full timePosition Description: Employee's primary function will be to assist in the facilitation of transitions for applicants to the program and the admitted Persons Serve between external and internal facets of the treatment team/referrals/support system. Incumbent will troubleshoot & manage the Tri-County telehealth network to facilitate user & end-user access,...
-
Case Manager II
4 weeks ago
Avon Park, United States Tri-County Human Services Full timeJob DescriptionJob DescriptionPosition Description:Employee’s primary function will be to assist in the facilitation of transitions for applicants to the program and the admitted Persons Serve between external and internal facets of the treatment team/referrals/support system. Incumbent will troubleshoot & manage the Tri-County telehealth network to...
-
Case Manager II
2 weeks ago
Avon Park, United States tri county human services Full timePosition Description: Employee's primary function will be to assist in the facilitation of transitions for applicants to the program and the admitted Persons Serve between external and internal facets of the treatment team/referrals/support system. Incumbent will troubleshoot & manage the Tri-County telehealth network to facilitate user & end-user access,...
-
Case Manager- Non-Clinical Home Care
2 weeks ago
Ridley Park, United States Serenity Care Resources LLC Full timeThe Case Manager will aid with managing the day to day Service Coordination and Case Management operations for Serenity Care Resources LLC. Must be proficient in supporting all administrative functions of Case Management, the Maximus Process and retention for all clients. The role requires interacting appropriately with elderly and disabled clients who have...