RN/LMSW/LPN- Case Manager
2 weeks ago
Job Title: Case Manager (RN/LMSW)
Department: Clinical Resource Management
Reports To: Manager of Case Management, System Director of Utilization and Case Management
Job Summary:
The (Nurse/Social Work) Case Manager is part of a multidisciplinary team who actively participates in the patient discharge planning process following federal and state regulations and accreditation standards. The Case Manager provides initial assessments, planning, care coordination and implementation of referrals to network and community facilities, agencies and resources to ensure a smooth transition of care. This includes the evaluation of patient and care team needs and the development, implementation and evaluation of an appropriate plan of care, making changes in response to changing patient needs.
Where it is within scope of practice, the Case Manager guides the utilization review process using recognized standards of care to assure appropriate medical necessity, level of care, patient status and related notifications are met. The Case Manager evaluates hospital admissions using evidence-based standards of care to assure care is medically necessary and delivered at the most appropriate level of care and guides patient progression across the care continuum to ensure safe and timely transitions to the appropriate level of care.
The Case Manager serves as a patient advocate. They evaluate the needs of clients (individuals, families, children, etc.), identify gaps in care, and create a plan to facilitate outpatient referrals and service coordination while working to identify, track and eliminate barriers to discharge.
Job Responsibilities include:
- Attends multidisciplinary rounds, working with teams to develop safe and appropriate transitions of care.
- Ensures patient demographics, insurance, primary care provider, and advanced directives are up to date in EMR.
- Communicates payer coverage and as indicated to patients/families/decision-makers. Facilitates insurance navigation/coverage where indicated.
- Maintains working knowledge of the organizational and department objectives and goals and takes actions to achieve targeted outcomes.
- Maintains current knowledge of federal, state and accreditation standards related to UR and Discharge Planning requirements.
- Maintains high visibility and is readily approachable.
- Communicates routinely and effectively with care teams, patients, families and guests.
- Remains calm in stressful scenarios and able to resolve conflict independently, appropriately escalating concerns as indicated.
- Regularly attends team meetings. Seeks information missed where unable.
- Demonstrates and promotes teamwork, appropriately shares knowledge with coworkers.
- Demonstrate strong written and verbal communication skills. Enforces appropriate written and verbal communication among team members.
- Demonstrates understanding of palliative/hospice/home care and other community-based referral requirements and appropriately facilitates referrals as indicated.
- Appropriately documents client interactions and intended plan of care.
- Monitors and appropriately escalates issues affecting patient safety and/or length of stay (LOS). Actively intervenes to facilitate patient progression and safe care transitions.
- Works in collaboration with ancillary personnel (i.e. physical therapy, pharmacy, diabetes education) to support identified patient care needs.
- Demonstrate strong written and verbal communication skills. Enforces appropriate written and verbal communication among team members.
- Exemplify satisfactory attendance and punctuality record as set forth by CHS policies.
- Exemplify a professional image in appearance, manner and presentation.
- Maintains patient confidentiality in the provision of quality care.
- Seeks learning opportunities to optimize job performance.
- Participates in system taskforces and other collaborative activities with community partners to support facility growth and transitions of care.
- Is flexible in assuming other responsibilities not noted above.
Requirements:
Education/Licensure - Current unrestricted NY state RN or LMSW licensure. Will consider those with BS in social work actively working towards their LMSW.
Experience - Minimum 2 to 3 years' experience in an acute care hospital setting or similar health care case experience. Knowledge of community-based organizations and strong communication, organizational, critical thinking and problem solving skills required. Computer literacy and knowledge of EMR systems. Demonstrates resilience in coping with challenging situations as well as the emotional stability and organizational skills necessary to meet the demands of the busy healthcare environment.
Physicality - Ability to stand, sit or ambulate for long periods. Ability to mobilize freely around units, transport self to site locations, and perform required data entry into EMR and alternate data management systems. Ability to transport self to customer base.
Cayuga Health System Commitment to Diversity, Equity & Inclusion
Cayuga Health System commits to treat all people with dignity so that everyone who comes to us is safe, cared for, and respected. We will support the growth of our employees and the health of our community by embracing the rich diversity of social and cultural identities, needs, and life circumstances of all people. We strive to recognize and overcome personal biases and systemic policies that marginalize others and contribute to disparities in healthcare access, equitable care, and good health outcomes.
Cayuga Health is dedicated to our vision for diversity, equity, and inclusion. As we strive towards our vision, we welcome the opportunity to work alongside a diverse range of employees.
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