Case Manager, Full Time, Days

Carolina Pines Regional Medical Center • Hartsville, SC

82d

About The Position

At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. The position coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. It follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery, and compliance with external review agencies. The role provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation, and overall evaluation of individual patient needs. It enhances the quality of patient management and satisfaction, promoting continuity of care and cost-effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.

Requirements

• Graduate of an accredited program required: LPN/LVN or RN.
• Master of Social Work with licensure as required by state regulations or Bachelor of Social Work with licensure as required by state regulations.
• Healthcare professional licensure required as LPN/LVN, Registered Nurse, or Licensed Clinical Social Worker (LCSW) or Licensed Social Worker (LSW) if required by state regulations.
• One year of experience in a healthcare setting.
• Experience in case management, utilization review, or discharge planning is a plus.

Responsibilities

• Assist in coordinating clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
• Assist with effective care coordination and efficient care facilitation.
• Remain current regarding reimbursement modalities, community resources, case management, psychosocial and legal issues that affect patients and providers of care.
• Appropriately refer high-risk patients who would benefit from additional support.
• Serve as a patient advocate.
• Participate in interdisciplinary patient care rounds and/or conferences.
• Collaborate with clinical staff in the execution of the plan of care and achievement of goals.
• Conduct comprehensive, ongoing assessment of patients and family to provide timely and safe discharge planning.
• Assist with comprehensive discharge planning.
• Utilize critical thinking to execute effective discharge planning.
• Conduct medical necessity review for appropriate utilization of services from admission through discharge.
• Promote effective and efficient utilization of clinical resources.
• Conduct timely and accurate clinical reviews, care collaboration, and coordination of continued stay authorization with payor.
• Conduct job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
• Serve on Hospital and Division committees when requested.

What This Job Offers

• Industry: Hospitals