Case Manager
4 days ago
Duties:
- Develops Case Management Plan: Reviews clinical findings and diagnostic reports to maintain a comprehensive understanding of the patient's current plan of care. Correlates the medical record findings with patient assessment findings and works with physicians to develop a comprehensive case management plan of care.
- Refers High Risk Patients to Social Services: Using specific criteria, identifies high-risk patients who potentially require psychosocial intervention and refers the patient to the social worker.
- Implements Actions to Prevent Readmissions: Conducts patient assessments and intervenes to proactively prevent readmissions; evaluates those who are readmitted to identify causes of the readmission and implements strategies to prevent future readmission.
- Develops and Implements Transition of Care Plan: Develops and documents a discharge/transition plan through collaboration with the interdisciplinary team. Ensures that activities to facilitate and coordinate the plan are being implemented and that the plan is continuously modified to meet any patient's changing needs.
- Monitors and Escalates Financial Management Issues: Communicates with the healthcare team and patient/caregiver regarding any issues related to payer or financial issues that may negatively influence the patient's post-acute care plan.
- Facilitates Patient Progression: Monitors hospitalized patient's length of stay (LOS), actively participates, and contributes to Care Rounds, proactively works with the clinical care team to meet
- expected length-of-stay and clinical targets/indicators and proposes solutions to address barriers to discharge to the healthcare team to ensure an efficient and effective transition plan of care.
- Coordinates Transitions of Care: Actively communicates with patients, families, physicians, care team members, and the Utilization Review Nurse to facilitate coordination of clinical activities to achieve a seamless transition from one level of care to another across the continuum.
- Maintains knowledge of Federal, State, and other regulatory agency rules and regulations including The Joint Commission, CMS, Medicare, including but not limited to, knowledge of CMS rules regarding Observation status, the 2 Midnight Rule, and Medicare Inpatient Only Procedures.
- Provides education and resources relevant to the effective progression of care, utilization of services, appropriate level of care, and safe patient transition to the patient/family and health care team.
- Identifies potential risk management and/or quality issues and works with the healthcare team to resolve such issues or refer them through the Chain of Command structure to the appropriate resource/committee.
Education:
BSN required
Languages:
English( Speak, Read, Write )
Skills:
2 years of acute care experience strongly preferred
Case Management, Managed Care. In Patient Case Management is required
Minimum Degree Required: Bachelor's Degree
City: Morristown
Schedule:
Start Date: 07/08/2024
End Date: 10/05/2024
Schedule Notes: 8a - 4p M- F
Hours Per Week: 37.50
Hours Per Day: 7.50
Days Per Week: 5.00
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