Case Manager
3 weeks ago
Case Manager
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, OT, PT, SLP, RT or LSW 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.
-
Case Manager
5 days ago
Tulsa, United States Saint Francis Health System Full timeThe case manager is responsible for facilitating the patient's hospitalization from pre-admission through discharge. The case manager coordinates with physician's, nurses, social workers, and other health team members to expedite medically appropriat Case Manager, Manager, Registered Nurse, Healthcare, Patient, Clinical, Medical
-
RN Case Manager
4 weeks ago
Tulsa, United States Trinity Employment Specialists Full timeJob DescriptionJob DescriptionRN Case Manager| Tulsa, OK| 80,000+Job Summary:The RN Case Manager is responsible for helping coordinate and evaluate the management of patients with acute and chronic conditions, across the care continuum, to achieve high quality care measured by positive patient outcomes. This position will work closely with members of the...
-
ADvantage Case Manager
1 week ago
Tulsa, United States LIFE Senior Services, Inc. Full timePOSITION SUMMARY: With required certification and training, provide certified ADvantage Case Management services though collaborating with ADvantage Members and their support systems, including family members, caregivers, etc., by assessing, facilitating, planning, advocating and monitoring health and social needs, thus enabling members to remain in their...
-
ADvantage Case Manager
2 days ago
Tulsa, United States LIFE Senior Services, Inc. Full timePOSITION SUMMARY: With required certification and training, provide certified ADvantage Case Management services though collaborating with ADvantage Members and their support systems, including family members, caregivers, etc., by assessing, facilitating, planning, advocating and monitoring health and social needs, thus enabling members to remain in their...
-
ADvantage Case Manager
4 hours ago
Tulsa, United States LIFE Senior Services, Inc. Full timePOSITION SUMMARY: With required certification and training, provide certified ADvantage Case Management services though collaborating with ADvantage Members and their support systems, including family members, caregivers, etc., by assessing, facilitating, planning, advocating and monitoring health and social needs, thus enabling members to remain in their...
-
ADvantage Case Manager
1 week ago
Tulsa, United States LIFE Senior Services, Inc. Full timePOSITION SUMMARY: With required certification and training, provide certified ADvantage Case Management services though collaborating with ADvantage Members and their support systems, including family members, caregivers, etc., by assessing, facilitating, planning, advocating and monitoring health and social needs, thus enabling members to remain in their...
-
ADvantage Case Manager
4 weeks ago
Tulsa, United States LIFE Senior Services Inc Full timeJob DescriptionJob DescriptionDescription:POSITION SUMMARY: With required certification and training, provide certified ADvantage Case Management services though collaborating with ADvantage Members and their support systems, including family members, caregivers, etc., by assessing, facilitating, planning, advocating and monitoring health and social needs,...
-
Case Manager
7 days ago
Tulsa, United States Ardent Health Full timeOverview Join our team as a evening shift, full-time, Case Management, Registered Nurse in Tulsa, OK. Fulfilling your purpose begins here: People First, Always. Here's how we take care of our people: Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company...
-
Case Manager
1 week ago
Tulsa, United States Ardent Health Full timeOverview Join our team as a evening shift, full-time, Case Management, Registered Nurse in Tulsa, OK. Fulfilling your purpose begins here: People First, Always. Here's how we take care of our people: Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company...
-
Case Manager
1 week ago
Tulsa, United States Hillcrest Healthcare System Full timeOverviewJoin our team as a evening shift, full-time, Case Management, Registered Nurse in Tulsa, OK. Fulfilling your purpose begins here: People First, Always. Here's how we take care of our people: Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company match,...
-
Case Manager
3 weeks ago
TULSA, United States Hillcrest Medical Center Full timeOverviewJoin our team as a evening shift, full-time, Case Management, Registered Nurse in Tulsa, OK. Fulfilling your purpose begins here: People First, Always. Here’s how we take care of our people:Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company...
-
Case Manager
4 weeks ago
Tulsa, United States Hillcrest Medical Center Careers Full timeOverviewJoin our team as a evening shift, full-time, Case Management, Registered Nurse in Tulsa, OK. Fulfilling your purpose begins here: People First, Always. Here’s how we take care of our people:Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company...
-
Case Manager
3 weeks ago
TULSA, United States Hillcrest Medical Center Careers Full timeOverviewJoin our team as a evening shift, full-time, Case Management, Registered Nurse in Tulsa, OK. Fulfilling your purpose begins here: People First, Always. Here’s how we take care of our people:Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company...
-
Case Manager
4 weeks ago
Tulsa, United States Hillcrest Medical Center Full timeOverviewJoin our team as a evening shift, full-time, Case Management, Registered Nurse in Tulsa, OK. Fulfilling your purpose begins here: People First, Always. Here’s how we take care of our people:Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company...
-
Case Manager
3 weeks ago
TULSA, United States Hillcrest Medical Center Full timeOverviewJoin our team as a evening shift, full-time, Case Management, Registered Nurse in Tulsa, OK. Fulfilling your purpose begins here: People First, Always. Here’s how we take care of our people:Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company...
-
RN Case Manager
3 weeks ago
Tulsa, United States Hospice of Green Country Full timeJob DescriptionJob DescriptionPosition: RN Case ManagerReports to: Director of Patient CareDepartment: Patient Care ServicesFSLA Status: Exempt Job Summary: The RN Case Manager is responsible for coordinating care of assigned patients; performing skilled assessments of patient's physical, emotional and mental condition; providing skilled interventions...
-
Case Manager
7 days ago
Tulsa, United States Encompass Health Full timePositions Available:Part-Time 32 hours, benefit eligible PRNMore personalized patient care More professional impact BE THE CONNECTION. In your role as case manager, you can be the connection between exceptional care and the positive effect it has on every patient during their stay with us. Make an impact in a more profound way with your clinical and...
-
Case Manager I/II
1 week ago
Tulsa, United States Oklahoma Human Services Full timeCase Manager I/II This position is located in Tulsa, Oklahoma. Annual Salary: Level I H21A - $ 40,000.87 + Full State Employee Benefits Level II H21B - $43,000.94 + Full State Employee Benefits Travel is extensive. Must possess a valid driver's license and must maintain required car insurance. Minimum Qualifications: Case Manager - Level I ...
-
Case Manager I/II
3 weeks ago
Tulsa, United States Oklahoma Human Services Full timeJob DescriptionJob DescriptionCase Manager I/IIThis position is located in Tulsa, Oklahoma.Annual Salary:Level I H21A - $ 40,000.87 + Full State Employee BenefitsLevel II H21B - $43,000.94 + Full State Employee BenefitsTravel is extensive. Must possess a valid driver's license and must maintain required car insurance. Minimum Qualifications:Case...
-
Case Manager CARES
4 weeks ago
Tulsa, United States Mental Health Association of Oklahoma Full timeJob DescriptionJob DescriptionUnder immediate to general supervision, the CARES Case Manager will provide support to the Police and Fire Clinical Coordinator. This position will focus on support services for the Community Assistance Referral and Educational Services (CARES) program, which targets individuals who are identified as the top utilizers of city...
