Case Manager
1 week ago
The Case Manager is a key member of the healthcare team, responsible for coordinating the care and services of selected patient populations across a continuum of care. This role requires strong communication and organizational skills, as well as the ability to work effectively with multidisciplinary teams.
Key Responsibilities- Coordinate and collaborate with physicians, providers, and other healthcare professionals to ensure patient goals, plans of care, and progress are met.
- Develop, implement, and maintain work standards and procedures that comply with ARH policies and regulatory requirements.
- Maintain up-to-date knowledge in the field to recommend new services, products, and equipment.
- Assess, develop, implement, and monitor comprehensive plans of care through an interagency multi-disciplinary team process.
- Revised and adjust plans of care daily to accommodate patient needs based on ongoing assessments.
- Assume responsibility and accountability for care plan effectiveness and patient outcomes.
- Assess the appropriateness of care levels, diagnostic testing, and clinical procedures, as well as quality and clinical risk issues.
- Review patient admission data to determine suitability of care levels in accordance with hospital-sanctioned ISDA criteria and/or other established criteria.
- Develop, implement, monitor, and evaluate clinical pathways and variances.
- Monitor patient progression through clinical pathways.
- Communicate continually with patients, families, medical staff, caregivers, and third-party payors as necessary.
- Assist patients and families with educational processes prior to admission, during hospital stays, and after discharge, as indicated.
- Ensure patients understand third-party payer guidelines and arrange discharge planning referrals as ordered by patients' physicians.
- Develop and maintain a positive work climate and support the overall team effort of the hospital.
- Assist in collecting and analyzing outcome data.
- 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 requirements 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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