LVN / Case Management Coordinator - Brownwood

Job description

Case Management Coordinator
Education: Associate degree or Licensed Vocational Nurse
Work Experience:
• 1-2 years of recent acute care experience or
• 1-2 years of recent skilled nursing home experience or
• 3-5 years of other related healthcare experience

Required Skills; Knowledge and Abilities :
• Ability to demonstrate advanced communication and interpersonal skills with all levels of internal and external customers; including but not limited to medical staff; patients and families; clinical personnel; support and technical staff; external agencies; and members of the community.
• Ability to engage in complex clinical decision-making.
• Ability to show strong commitment to interdisciplinary collaboration and communication.
• Ability to demonstrate strong computer skills; knowledge of Microsoft Office products necessary.
• Ability to demonstrate strong critical thinking and analysis skills and conflict resolution.
• Ability to demonstrate excellent human relations skills.
• Ability to show creative problem solving.
• Ability to be proficient with organization and planning.
• Ability to show initiative and work with no supervision.
• Ability to tolerate frequent interruptions and demanding workload.
• Ability to become proficient in applicable software programs within 6 months of hire.

Essential Job Functions:
• Demonstrates consistent adherence to company policies and procedures related to attendance and tardiness; professional appearance; corporate compliance; and applicable legal requirements.
• Communicates using the components of AIDET (Acknowledge; Introduce; Duration; Explanation; Thank you).
• Collaborates with internal and external customers functioning as the primary point of contact both in person and over the phone.
• Answers department office phone and provides routine general information to customers; routing to team members as required.
• Schedules and coordinates meetings and external mailings as required.
• Responsible for maintaining a neat and organized department supply room; coordinating the purchase and distribution of supplies; replenishing manufacturer coupons and maintaining the supply/copies of required forms.
• Keeps up with incoming and outgoing mail and distributes as needed; including uploading into Medical Records; routing to other departments or scanning into the department shared drive.
• Completes departmental fire drill critiques; environment of care audits; manages the electronic fax folder and distributes case manager patient assignment list to UR and Hospitalists.
• Establishes an organized department shared drive of pertinent information; contacts; instructions and forms; with continued ongoing maintenance of the drive as new or revised data is received.
• Prepares the Case Management On-Call Schedule monthly and distributes as required.
• Tracks patients for receipt of insurance authorization for inpatient or observation length of stay; enters authorization into the Dragonfly system; routes to medical records and notifies Manager of UR of any received denials or adverse determinations in a timely manner.
• Assists the Case Managers as needed in sending referrals to outside agencies; following up on outstanding equipment delivery and arranging patient transport as needed.
• Assists the Case Managers with the delivery of the Important Message from Medicare (IMM) to patients transitioning from Observation Status to Inpatient Status by tracking these conversions daily; along with assisting with delivery of the IMM on discharge as needed.
• Submits for EMS pre-authorization for nonemergent transport for Case Managers by completing insurance specific forms and attaching clinical documentation; follows up to ensure receipt of authorization letter and submits to EMS provider for billing purposes.
• Conducts monthly chart audits for compliance metrics as assigned by CM Director; updating tracking tables for monthly compliance meetings and quarterly UM Committee meetings.