Case Manager - Care Coordination - Days - FT

Job description

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