Case Manager Care Coordinator
7 days ago
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The Case Manager is responsible for directing and coordinating the functions and activities of health care services delivery and discharge planning with the multidisciplinary team. The Case Manager facilitates communication and coordination between the healthcare team members involving the resident and family in the decision-making process. Activities include encouraging appropriate use of health care services, improving quality of care, and maintaining cost-effectiveness on a case-by-case basis. The Case Manager is responsible for establishing a positive relationship with payer sources and initiating necessary documentation to re-authorize the resident’s continued stay.
**JOB-SPECIFIC RESPONSIBILITIES**:
- Observe patients, listen to concerns, and record the observations.
- Monitor the health and safety of patients, the signs and symptoms of their mental illness, and report any concerns to the appropriate staff per reporting policies.
- Work effectively with the member’s support system and clinical/therapeutic groups.
- Act as an advocate and liaison for members’ access to resources to support service plan goals.
- Participates in individual and team supervisions as required by licensing, agency, funding source, or as requested by supervisor
- Coordinates with the treatment team for admission conferences with patients and/or support persons.
- Contacts external payor source case manager/representative of the patient’s/resident’s admission and reviews schedule for clinical updates
- Liaison with the resident’s interdisciplinary team to meet the resident’s treatment needs.
- Coordinates with the Program Director for weekly contact and documentation with payor sources and family/support persons of patient/resident.
- Coordinates with the interdisciplinary team to develop the patient’s/resident’s initial service plan
- Provides third-party payor sources with appropriate clinical documentation to assure re-certification.
- Presents a positive and helpful working relationship with all external case managers/representatives, community agencies, and other stakeholders.
- Acquires appropriate information to address payor denials necessary to receive payment.
- Appropriately document in the EMR regarding the patient’s/resident’s status, treatment progress, family issues, estimated length of stay, and discharge needs.
- Utilizes Meditech for “clinical notes” for billing documentation as needed.
- Arranges proper and timely discharge planning for patients/residents in coordination with family or support persons. Page 2 of 3 E6CASM
- Coordinates input and feedback from the interdisciplinary team, patient’s/resident’s family, or support persons for discharge.
- Identifies necessary community resources and verifies services are arranged to meet the patient’s/residents’ needs before discharge.
- Resolves patient’s/resident’s family or support person’s complaints or concerns to appropriate team members and follows up to ensure resolutions are acceptable to all parties.
- Exhibits a positive professional demeanor to residents and relevant parties, offering constructive communication, cooperation, and assistance to ensure satisfactory patient treatment.
- Provides effective assistance and promotes positive relations with co-workers to achieve a collaborative team approach.
- Provide timely information/feedback to the designated supervisor on any patient, resident/family/support person/payor source issues that could jeopardize the resident’s treatment, positive outcomes, or discharge planning issues.
- Maintain current training and participate in professional development
- Performs other duties as assigned.
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