Case Manager

3 weeks ago

Overland Park, United States PAM Health Full time
Job DescriptionJob Description

Case 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 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 time

    Cancer 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 Management

    20 hours ago

    Newbury Park, United States Dale Workforce Solutions Full time

    Title (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

    1 week ago

    Fruitland Park, United States Bell's Disability Consultants Full time

    Job DescriptionJob DescriptionCompany DescriptionDisability Consultants at Chris Bell's Office is dedicated to providing assistance and support for individuals with disability claims. Located in Fruitland Park, FL, we prioritize our clients' needs and aim to offer exceptional service throughout the claims process.Role DescriptionThis is a full-time...

  • Case Manager

    3 weeks ago

    Manassas Park, United States Bull Run Alcohol Safety Action Prog Full time

    Job 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 time

    Job 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

    2 days ago

    Manassas Park, United States Bull Run Alcohol Safety Action Prog Full time

    Job 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

    3 weeks ago

    Woodland Park, United States Resources for Human Development Full time $22

    Do 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...

  • Manager Case Management

    1 week ago

    Orange Park, United States Becker Health Full time

    Manager 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...

  • Manager Case Management

    2 days ago

    Orange Park, United States Becker Health Full time

    Manager 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

    6 days ago

    Walnut Park, United States InsideHigherEd Full time

    Job 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

    2 days ago

    Highland Park, United States Kass and Moses, PC Full time

    Job 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...

  • Ssvf Case Manager

    7 days ago

    Lexington Park, United States Three Oaks Center, Inc. Full time

    **Position Overview**: The Supportive Services for Veteran Families Case Manager will provide case management and advocacy to veteran clients assigned to them. The primary focus of this position is to support clients in their efforts to gain housing stability, financial stability, and life skills development to prevent and end homelessness. **Essential Job...

  • Case Management Coordinator hybrid

    7 days ago

    Monterey Park, United States Astrana Health Full time

    Job Title: Case Management Coordinator Department: Health Services - ICM **About the Role**: Assist Case Manager(s), Specialist, Supervisor & Manager in assigned area of responsibility, including compiling information (open & close inpatient cases), fax authorization letters to providers, including sending denial letters and keeping records. Provide and...

  • RN Case Manager

    1 week ago

    Orland Park, United States Duly Health and Care Full time

    OverviewFull-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 walls of our work. Duly Health and...

  • RN Case Manager

    1 week ago

    Tinley Park, United States Duly Health and Care Full time

    OverviewFull-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 walls of our work. Duly Health and...

  • Case Manager

    4 weeks 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

    4 weeks 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

    4 days ago

    Orland Park, United States DuPage Medical Group Full time

    RN Case Manager - Care Ally Overview 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

    1 week ago

    Tinley Park, United States Dupage Medical Group Full time

    RN 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...

  • RN Case Manager

    1 week ago

    Orland Park, United States Dupage Medical Group Full time

    RN 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...