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Catastrophic Nurse Case Manager
2 months ago
We are seeking a highly skilled and experienced Catastrophic Nurse Case Manager to join our team at ExpertHiring. As a Catastrophic Nurse Case Manager, you will be responsible for identifying, assessing, planning, coordinating, implementing, monitoring, and evaluating options and services for individuals requiring case management services.
Key Responsibilities- Case Management: Identify, assess, plan, coordinate, implement, monitor, and evaluate options and services for individuals requiring case management services.
- Quality Outcomes: Provide quality, cost-effective outcomes for clients through collaboration and communication with clients, families, physicians, and other healthcare team members.
- Case Processing: Process cases utilizing client outcome management models and tools.
- Authorization and Release: Obtain written authorization for case management services and release of information.
- Client Assessment: Assess clients/families to identify strengths and resources, problems, psychosocial, financial, and medical history, current status, diagnosis, prognosis, functional status, goals, current treatment plan, and needs.
- Plan of Care: Develop a plan of care with clients through interdisciplinary collaboration, identifying realistic short- and long-term goals.
- Service Coordination: Identify, secure, and coordinate services and resources to implement the plan.
- Service Monitoring: Monitor services being provided for continued appropriateness and report to clients and insurance carriers.
- Progress Evaluation: Evaluate clients' progress, the plan, and the appropriateness of services provided, with modifications as necessary.
- Client Education: Provide ongoing instruction to clients and families regarding the injury/disease process, treatment options, and present care.
- Self-Advocacy: Promote clients'/families' self-advocacy skills to achieve maximum self-sufficiency.
- Benefit and Funding Knowledge: Have knowledge of the benefit package and all available funding sources and systems of care, and coordinate with payers for authorization of payment.
- Reporting: Provide in-depth reporting of outcomes encompassing clinical, functional, financial, and customer satisfaction areas.
- Communication: Demonstrate effective, accurate, and timely verbal and written communication in all work situations.
- Liability and Quality Care: Identify and disclose all situations that might result in exposure to legal liability and/or are indicative of poor quality care negatively affecting clients.
- Travel: Frequently travel to patient appointments.
- Other Duties: Perform other related duties as assigned in accordance with the necessary job function.
- Education: Registered nurse with a BSN preferred.
- Certification: CCM or equivalent certification.
- Experience: Three years or more of related experience and/or training or equivalent combination of education and experience.
