Case Manager - Care Coordination - Days

Coordinates the efforts of patient, family, and healthcare professionals to develop a plan of care across the continuum based on identified needs. Reviews and assesses the appropriateness of patient admissions and continued stays in accordance with established policies and procedures.

• Ensures implementation of the prescribed plan of care in collaboration with patient/family and healthcare providers.
  
  
  
  • Coordinates care and services across the continuum working directly with patient/ family, healthcare providers, staff, and payers.
  
  
  • Evaluates and communicates patient progress towards established outcomes.
  
  
  • Coordinates multi-disciplinary discharge planning to assess current and discharge needs.
  
  
  • Evaluates patient satisfaction and quality of care provided.
  
  
  • Provide post-discharge follow-up to ensure the progress of the discharge plan.
  
  


• Promotes quality and cost-effective interventions, resources, and outcomes utilizing a multidisciplinary team approach.
  
  
  
  • Reviews and determines necessity and appropriateness of hospitalization using established criteria to prevent denials of payment.
  
  
  • Refers appropriate cases to the physician advisor for intervention.
  
  
  • Serves as a liaison with healthcare providers, admissions, and medical records staff to assure continuity of patient care, discharge planning, and effective communications.
  
  
  • Arranges appropriate referrals for counseling, financial assistance, and discharge planning assistance as needed.
  
  
  • Assists in the collection, delivery, and tracking of information for Performance Improvement, Risk Management, and Infection Control.
  
  

Education:

• Associate's Degree


• Bachelor's Degree


• Graduate of an accredited program in nursing


• Bachelor of Science in Nursing (BSN)

Experience:

• 3


•  


• Clinical experience as a registered nurse in an acute care facility


• Advanced quality management, utilization management, case management and/or DRG documentation compliance principles

Skills:

• Excellent customer service and communication skills


• Strong organizational and problem-solving skills


• Advanced statistical and spreadsheet/database application skills