Complex Case Coordinator

2 weeks ago


Bel Air, Maryland, United States University of Maryland Medical System Full time
Job Overview

Company Overview:
University of Maryland Medical System (UMMS) is committed to delivering exceptional healthcare services, leveraging advanced technology and clinical expertise to enhance patient experiences. Our mission is to foster a healthier community through a comprehensive, integrated health delivery system that prioritizes quality care for all.

Position Summary:
The Complex Case Coordinator plays a pivotal role in collaborating with healthcare professionals, community resources, and patients/families to ensure optimal patient outcomes throughout the care continuum. This role involves managing a focused caseload that necessitates intensive care coordination due to intricate social circumstances, legal considerations, and connections with various support services.

Key Responsibilities:

  1. Identify high-risk patients with complex needs early in their hospital stay to formulate and implement tailored care plans addressing their specific requirements.
  2. Work alongside an interdisciplinary team to develop, adjust, and execute appropriate discharge strategies, ensuring safety and continuity of care.
  3. Communicate significant findings to leadership that may impact care coordination, discharge planning, or length of stay.
  4. Conduct comprehensive assessments encompassing medical, social, emotional, and financial aspects to aid in the creation of effective care plans.
  5. Facilitate legal preparation sessions for staff required to provide expert testimony in legal matters, attending court as necessary.
  6. Provide patients and families with relevant community resources and services.
  7. Maintain precise and timely documentation of services and actions in the designated electronic medical record system.
  8. Engage in Care Transition Rounds or ensure detailed handoffs to colleagues to promote safe discharge planning and minimize length of stay.
  9. Foster effective communication with physicians, nurses, and other multidisciplinary team members to enhance patient management throughout the healthcare system.
  10. Identify the need for and coordinate peer consultations or family conferences to address complex service and resource coordination.
  11. Establish and nurture collaborative relationships with post-acute care representatives to facilitate timely and secure patient transfers.
  12. Initiate referrals to home healthcare, hospice, skilled nursing facilities, and other necessary services to ensure smooth transitions to alternative care levels.
  13. Continuously evaluate and update community resource information to ensure accuracy and relevance for patients and families.
  14. Participate in identifying opportunities for performance improvement and contribute to departmental initiatives and goals.
  15. Report safety events through the designated tracking system.
  16. Assist in orienting new team members and students.
  17. Commit to ongoing professional development and continuing education requirements for licensure.
  18. Support special projects and additional duties as assigned.

Qualifications:

Education & Training: A valid Maryland Social Work license (LMSW or LCSW) or a Maryland nursing license is required. A Bachelor's degree is preferred.

Experience: A minimum of three years of relevant hospital case management experience is required, along with prior acute care social work or nursing experience.

Skills & Abilities: Candidates should demonstrate proficiency in critical thinking, effective communication, time management, and adaptability to changing environments. Knowledge of Medicare and Medicaid regulations is preferred.

All information will be kept confidential in accordance with EEO guidelines.



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