Patient Care Resource Coordinator

1 week ago

Westminster, Colorado, United States Kindred Hospitals Full time

Job Overview:

The Resource Case Manager acts as a pivotal authority in case management, delivering operational proficiency within the case management divisions across various Kindred hospitals. This role involves orchestrating and enhancing the care of the patient demographic through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. The Resource Case Manager also serves as a key resource, mentor, and educator to staff, providing training related to resource allocation, discharge strategies, and the psychosocial dimensions of healthcare delivery. This position ensures continuous patient support throughout the care continuum, optimizing resource utilization, service provision, and adherence to external review standards. Through comprehensive assessments, care planning, implementation, and evaluation of individual patient requirements, the Resource Case Manager enhances the quality of patient management and satisfaction, fostering continuity of care and cost efficiency by integrating case management, utilization review, and discharge planning functions. Additionally, this role collaborates with external stakeholders, referral sources, and payors to facilitate and coordinate the discharge planning process while advocating for patients and their families.

Key Responsibilities:

Care Coordination

Acts as a key resource in the daily management of patient care to support the development, monitoring, and refinement of treatment plans. Collaborates with the Director of Case Management to ensure compliance with CMS, State, and JCAHO regulations and standards, as well as Kindred policies, including documentation and record-keeping requirements. Engages actively in surveys and audits. Coordinates clinical and psychosocial initiatives with the Interdisciplinary Team and Physicians. Monitors all aspects of patient care to ensure effective coordination and efficient service delivery. Maintains current knowledge regarding reimbursement models, community resources, case management practices, and psychosocial and legal issues impacting patients and care providers. Appropriately identifies high-risk patients who may benefit from additional support. Serves as an advocate for patients, fostering a collaborative relationship to empower patients and families in making informed decisions. Demonstrates understanding of growth and development principles across the lifespan and the skills necessary to provide age-appropriate care to the patient population served. Participates in interdisciplinary patient care rounds and/or conferences to review treatment objectives, optimize resource utilization, and educate patients and families on identified post-hospital needs. Collaborates with clinical staff in developing and executing care plans and achieving objectives. Coordinates with the interdisciplinary care team, physicians, patients, families, post-acute providers, payors, and others in planning patient care throughout the care continuum.

Discharge Planning

Conducts thorough, ongoing assessments of patients to facilitate timely and safe discharge planning. Develops comprehensive discharge plans for each patient, utilizing critical thinking to ensure effective execution. Communicates efficiently and effectively with patients and families throughout the discharge process.

Utilization Management

Conducts medical necessity reviews to ensure appropriate utilization of services from admission through discharge. Promotes effective and efficient use of clinical resources. Conducts timely and accurate clinical reviews, care collaboration, and coordination of continued stay authorizations with payors. Qualifications

Education:

Graduate of an accredited program required:

RN, BSN preferred

OR

Master of Social Work with licensure as required by state regulations;

OR

Bachelor of Social Work with licensure as required by state regulations

Licenses/Certification:

Healthcare professional licensure required as Registered Nurse or Licensed Clinical Social Worker (LCSW) or Licensed Social Worker (LSW) if required by state regulations. Certification in Case Management preferred.

Experience:

Two years of experience in a healthcare setting preferred, particularly in acute or LTACH environments. Prior experience in case management, utilization review, or discharge planning is preferred.

Knowledge/Skills/Abilities/Expectations:

Familiarity with government and non-government payor practices, regulations, standards, and reimbursement processes. Understanding of Medicare benefits and insurance processes and contracts. Knowledge of accreditation standards and compliance requirements.

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