Case Coordinator ER
2 weeks ago
Job SummaryCollaborate with and serve as an expert resource to the health care team to enhance the delivery of patient care services. Efficiently coordinate patient needs to assure high quality patient care, reduce length of stay and resource utilization and ensure reimbursement drawing on a broad clinical and systems management knowledge base.Responsibilities•Collaborate with the medical staff and serve as a resource expert regarding documentation, application of appropriateness criteria, alternate levels ofcare, patient classification, and denial information.•Facilitate communication with patients, physicians, and families in order to avoid insurance and medicare denials.•Direct the timely implementation of the plan of care in collaboration with the multidisciplinary team. Serve as a liaison to ensure that all elements critical to the plan of care have been communicated to the patient, family, and members of the multidisciplinary team.•Educate multidisciplinary team regarding documentation in order to assure continuity of care and hospital/physician reimbursement for all services.•Utilize assessment skills to identify and anticipate discharge and other needs of patients/families.•Coordinate needs assessments for select patient groups with similar diagnosis or problems (ex: CHF).•Assist with the development of carepaths, monitor patient status on carepath and tracks variances to the plan of care.•Evaluate care based on standards of care and QI process of select population or unit.•Act as a resource to assist others with patient care management.•Ensure patient rights are sustained and safeguard patient privacy and confidentiality.•Coordinate utilization and implementation of internal and external resources.•Facilitate group process and interdisciplinary problem solving.•Monitor trends and report practice issues of the multidiscipline health care team that impacts finances and quality care issues. Implement appropriate measures to resolve issues.•Provide input to department managers on the quality of care which is being provided in the departments (ex: nursing, ancillary).•Monitor and review quality care issues being provided on a unit level with Department Manager, Clinical Physician Director, and Clinical Quality Specialist.•Direct attending and consulting physicians, residents, staff nurses andother members of the multidisciplinary team to address system processes that impact the timely delivery of care.•Collaborate with all members of the multidisciplinary team to facilitate the case coordination process for designated case load. Monitor the patient's progress, intervening as necessary and appropriate, to ensure the plan of care and services provided are patient focused, high quality, efficient, and cost-effective.•Support Collaborative Practice Committees and develop methods to optimize resource utilization in order to achieve quality outcomes.•Collaborate with multidisciplinary team to identify patient needs, assess patient progress against the caremap, address family and patient discharge needs and make appropriate referrals to address those needs. Facilitate identified improvement processes are appropriate.•Facilitate/ensure discharge planning occurs in a timely manner including coordination of patient transfers/discharge to alternate care facilities including rehab, nursing home, personal care home, or skilled nursing facility, communication with patient and family regarding discharge needs.•Assist with development and tracking of quality indicators and collection of variance data.•Apply variance tracking data to facilitate system changes or changes in practice, and facilitate quality management activities including screening, focus studies, and others. Recommend improvements based on variance tracking.•Identify educational needs of the staff and physicians and provide continuing education.•Participate in hospital/unit committees as requested.•Maintain communication with patients, families, and visitors to ensure high level quality care for patient satisfaction.•Keep the patients medical record current.•Integrate continuous, quality improvement into department and institution operations, and demonstrate a commitment to the process.•Serve as patient/family advocate.•Initiate collaborative action towards identified barriers to quality.Knowledge, Skills & AbilitiesPatient Group Knowledge (Only applies to positions with direct patient contact)The employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department's identified patient ages. Specifically the employee must be able to demonstrate competency in: 1) ability to obtain and interpret information in terms of patient needs; 2) knowledge of growth and development; and 3) understanding of the range of treatment needed by the patients.Competency StatementMust demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist.Common Duties and Responsibilities (Essential duties common to all positions)1. Maintain and document all applicable required education. 2. Demonstrate positive customer service and co-worker relations. 3. Comply with the company's attendance policy. 4. Participate in the continuous, quality improvement activities of the department and institution. 5. Perform work in a cost effective manner. 6. Perform work in accordance with all departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations. 7. Perform work in alignment with the overall mission and strategic plan of the organization. 8. Follow organizational and departmental policies and procedures, as applicable. 9. Perform related duties as assigned.Education •Bachelor's Degree (Required) Experience:7-10 years utilization and case management with 5 years clinical experience pertinent to the position.Substitution:May substitute Associates Degree + 9 Years Relevant Experience for the Bachelors Degree and 7 years experience.Credentials •Registered Nurse (Required)Work Schedule: DaysStatus:Full Time RegularLocation: General HospitalLocation of Job: US:WV:CharlestonTalent Acquisition Specialist: Lauren R. Lane lauren.lane@vandaliahealth.org
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RN - Case Manager
5 days ago
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RN - Case Manager
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Charleston, United States LaBine and Associates Full timeJob DescriptionJob DescriptionAre you an RN with Case management experience? If you are looking for a great team environment and a solid career opportunity, we want to talk to YOU!Our client is hiring a fulltime Director of Case Management. This person has the overall responsibility for managing and coordinating department activities. The Director ensures...
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Director Case Manager RN
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Charleston, United States SES Staffing & Recruiting Full timeJob Summary and Qualifications The Facility Case Management Director has the overall responsibility for managing and coordinating department activities. The Director ensures staff compliance with organizational policies and external regulatory agencies and takes leadership responsibility to coordinate the integration of the department's patient care and...
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Case Manager for Law Firm
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Nurse Case Manager I
5 days ago
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Charleston, United States Lutheran Services Carolinas Full timeWe are hiring a compassionate, motivated, humanitarian to work as our Reception and Placement Case Manager. The R&P Case Manager's focus is to ease client’s transition to life in the US and assist them along the path to self-sufficiency. The R&P Case Manager will provide extensive case management to newly arriving refugees receiving Reception and...
