Case Manager - PRN- Day Shift

Description

Job Summary

Case Manager is responsible for advocating and coordinating the care needs for patients with regards to assessments, developing care plans, scheduling appointments, ensuring quality care, participating in interdisciplinary team meetings, and resource needs to support patient success. This position also assists and coordinates Swing Bed patient recruitment, transfer, admission, case needs, and discharge related activities. Case Management assists in utilization review activities. Responsible for obtaining all required paperwork for patients within their care.

Duties and Responsibilities

· Review and assess each hospital admission concurrently to determine post-discharge needs and establish discharge plan. Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors.

· Supports and maintains a culture of safety and quality.

· Knowledgeable of criteria for Medicare, Medicaid, and private insurance coverage.

· Knowledgeable of CMS regulations and executes requirements set forth by CMS for discharge planning.

· Maintains current knowledge of resources available within the community, maintains supply of resource materials to be distributed to patients when needed. Is able to obtain other resources as needed.

· Participate in Community Service Provider Meeting and other collaboration as needed.

· Participate in Interdisciplinary Team Meeting each weekday, collaborate with team members to assess patient progress toward meeting discharge goals.

· Initiates and maintains ongoing communication with the patient and patient’s family/caregiver, medical provider, and hospital team members to assess discharge needs.

· Interacts professionally with patient/family/caregiver and involves patient/family/caregiver in the formation of the plan of care.

· Documents discharge planning efforts in an ongoing manner in patient’s electronic medical record in meeting with current standards and policies.

· Acts on performance improvement issues identified during Quality meetings.

· Maintains and respects confidentiality of patient/physician/staff information

· Collaborates with the Business Office Manager and onsite eligibility worker, where patients require such assistance.

· Accurately determines type of assistance/setting/resources necessary for the patient/family/caregiver and provides appropriate resources/assistance list of facilities.

· Coordinate/oversee completion of Medicare required documentation in accordance with Medicare conditions of participation.

· Assist in data collection and activities with Utilization Review Committee Meetings.

· Coordinate internal admissions and outside referrals for the Swing Bed Program.

· Actively participates in other meetings as appropriate.

· Demonstrates an ability to be flexible, organized and function under stressful situations.

· Maintains a good working relationship both within the department and with other departments.

· Provides follow up phone calls to discharged patients within 3 business days of discharge to ensure plan of discharge was appropriate and effective for patient.

· Actively engage in quality improvement activities.

Requirements

Minimum Requirements

· Licensed Practical Nurse or Licensed Registered Nurse or Licensed Social Worked in State of Idaho.

· Working knowledge of criteria for Medicare, Medicaid, and any other insurance coverage.

· Experience in providing patient care.

· BLS Certified

Preferred Requirements

· ACLS/PALS Certified

Skills/Competencies

· Read, write, and comprehend simple instructions, short correspondence, and memos in English.

· Effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.

· Add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.

· Basic computer knowledge.

· Compute rate, ratio, and percent and to draw and interpret bar graphs.

· Apply commonsense understanding to carry out instructions furnished in written, oral or diagram form and deal with problems involving several concrete variables in standardized situations.

Physical Requirements

Perceive the nature of sounds by the ear, express or exchange ideas by means of spoken word, perceive characteristics of objects through the eyes, extend arms and hands in any direction, seize, hold, grasp, turn, or otherwise work with hands, pick, pinch, or otherwise work with fingers, perceive such attributes of objects or materials as size, shape, temperature, or texture; and stoop, kneel crouch, and crawl. Must be able to lift 20 pounds maximum with frequent lifting, carrying pushing, and pulling of objects weighing up to 50 pounds. Continuous walking and standing. Must be able to identify, match, and distinguish colors.