Care Coordinator

2 weeks ago

Beckley, West Virginia, United States Appalachian Regional Healthcare Full time
Job Title: Case Manager

Job Summary:

The Case Manager is a critical role within our healthcare team, responsible for coordinating the care and services of selected patient populations across a continuum of care. This position ensures and facilitates the achievement of optimal quality, clinical, and cost outcomes, while coordinating services and resources needed by the patient and family.

Key Responsibilities:

  • Coordinates and collaborates with physicians, providers, multidisciplinary teams, and other healthcare professionals concerning patient goals, plans of care, and progress.
  • Develops, implements, interprets, and maintains work standards and procedures that are in compliance with ARH's policies and governmental regulations.
  • Maintains up-to-date knowledge in the field to recommend new services, products, and equipment.
  • Assesses, develops, implements, and monitors comprehensive plans of care through an interagency multi-disciplinary team process in conjunction with the patient and family in internal and external settings.
  • Revises and adjusts the plan of care daily to accommodate the needs of the individual patient based on continuing assessment of patient condition.
  • Assumes responsibility and accountability for the care plan and effectiveness and patient outcomes.
  • Assesses the appropriateness of the level of care, diagnostic testing, and clinical procedures, quality and clinical risk issues, and documentation of medical record completeness.
  • Reviews all patient admission data to determine the suitability of the level of care in accordance with hospital-sanctioned ISDA criteria and/or other established criteria.
  • Develops, implements, monitors, and evaluates clinical pathways and clinical pathway variances.
  • Monitors patients' progression through clinical pathways.
  • Communicates continually with patients, families, medical staff, caregivers, and third-party payors as necessary.
  • Assists patients and families with the educational process prior to admission, during hospital stays, and after discharge, as indicated.
  • Ensures patients understand third-party payer guidelines and arranges discharge planning referrals as ordered by patients' physicians.
  • Develops and maintains a positive work climate and supports the overall team effort of the hospital.
  • Assists in collecting and analyzing outcome data.
  • Performs other duties as assigned or directed.

Qualifications:

  • BSN preferred with 5 years of experience in a hospital/community setting.
  • Must complete BSN or degree in other related field within 5 years.
  • RN with MSN or degree in other related field with 3 years of experience.
  • Must meet all licensure and certification in the state working.
  • Must obtain Certification of Case Management Society of America.
  • Excellent oral and written communication skills.
  • Must possess skills and proficiency in applying highly technical principles, concepts, and techniques central to the nursing profession.
  • Excellent organizational skills.
  • Must have a valid driver's license in the state working.

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