Case Manager

The Case Manager will provide comprehensive support and expertise through the assessment, planning, implementation, and evaluation of individual patient needs. This role focuses on improving patient care quality and satisfaction by ensuring continuity of care, cost-effectiveness, and seamless coordination between case management, utilization review, and discharge planning. The Case Manager is responsible for overseeing the care, coordination, and discharge planning for all patients, helping to ensure a smooth and effective transition through each phase of their healthcare journey.

DUTIES & RESPONSIBILITIES:

• Coordinate the integration of social services/case management functions into the patient care, discharge, and home planning processes with other hospital departments, external service organizations, agencies, and healthcare facilities.


• Promote effective and efficient utilization of clinical resources. Conducts review for appropriate utilization of services from admission through discharge.


• Initiates and presents “Medicare Important Notice” (IM) and other Medicare notices as appropriate.


• Communicates with physicians at regular intervals throughout hospitalization and develops an effective working relationship. Assist Physicians to maintain appropriate cost, case, and desired patient outcomes.


• Introduces self to patient and family and explains clinical case manager's role and process for patient and family to contact clinical case manager. Complete expanded assessment of patients and family needs at the time of admission. Complete psychosocial assessment. Assess the patient’s progress through the expected hospital course.


• Facilitates interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education, and identified post-hospital needs.


• Collaborate with clinical staff in the development and execution of the plan of care, and achievement of goals.  The employee will initiate and communicate the discharge plan to the health care team throughout the patient admission to ensure that discharge needs are identified and addressed in a timely manner.


• Coordinates the provision of social services to patients, families, and significant others to enable them to deal with the impact of illness on individual family functioning and to achieve maximum benefits from healthcare services.