Case Manager NEX

American Addiction Centers•Winston-Salem, NC

21h•$38 - $57•Onsite

About The Position

The Case Manager identifies patients who would benefit from Case Management interventions based on an initial screening assessment of discharge needs. This role assesses all relevant data and obtains information by interviewing the patient/family and performing an objective evaluation of patient needs. The Case Manager ensures that a Plan of Care is developed and implemented in conjunction with nursing to enhance client outcomes in a cost-efficient manner by defining desired patient outcomes (goals) with other members of the team. They collaborate with the patient, caregivers, the multidisciplinary team, and community service providers to effectively execute the Plan of Care and coordinate the discharge planning process, ensuring discharge planning needs are completed. The Case Manager evaluates and monitors the effectiveness of the discharge planning by facilitating changes in the Plan of Care as needed with all members of the multi-disciplinary team. They document Case Management actions in the Electronic Medical Record and communicate necessary information to providers and payors. This role participates in multi-disciplinary rounds to communicate discharge planning and drive patient progression through the system, establishing partnerships with physicians to achieve institutional goals and contribute to excellent patient care. The Case Manager identifies system issues and suggests interventions to the Supervisor to eliminate duplication in services and documents significant variances. They identify trends/process barriers and participate in the development of plans to ensure a method to move patients effectively through the care continuum. Additionally, the Case Manager monitors the medical necessity of admissions, continued hospitalization, and surgical procedures using criteria approved by the medical staff and evaluates the appropriate level of care for the patient, notifying Utilization Review staff of necessary changes. They utilize principles of quality improvement in every aspect of performance by participating in unit and organizational quality improvement activities to develop strategies to reduce or resolve variations in practice. This role provides age/developmentally-appropriate patient planning and communication in accordance with Age-Specific Care Guidelines for the specific age groups served and maintains a working knowledge of payer and reimbursement practices impacting the plan of care, demonstrating the ability to guide the patient and family through an evaluation of their options for post-discharge care.

Requirements

Graduate from an accredited school of nursing.
BSN required.
Minimum 5 years of relevant clinical experience.
Current licensure to practice as a Registered Nurse in the State of applicable state.
Good interpersonal, communication (verbal, nonverbal and listening skills) and written communication skills.
Computer skills (basic)

Nice To Haves

MSN preferred.
Previous Case Management experience preferred.
Certification in case management highly recommended within 2 years of employment.

Responsibilities

Identifies patients who would benefit from Case Management interventions based on an initial screening assessment of discharge needs.
Assesses all relevant data and obtains information by interviewing patient/family and performing objective evaluation of patient needs.
Ensures that a Plan of Care is developed and implemented in conjunction with nursing to enhance client outcomes in a cost efficient manner by defining desired patient outcomes (goals) with other members of team. Collaborates with the patient, caregivers, the multidisciplinary team and community service providers to effectively execute the Plan of Care. Facilitates. The Case Manager coordinates the discharge planning process; ensuring discharge planning needs are completed.
Evaluates and monitors the effectiveness of the discharge planning by facilitating changes in Plan of Care as needed with all members of the multi-disciplinary team.
Documents Case Management actions in the Electronic Medical Record and communicates necessary information to providers and payors.
Participates in multi-disciplinary rounds to communicate discharge planning and be the driver of patient progression through the system. Establishes partnerships with physicians to achieve institutional goals and contribute to excellent patient care by the organization.
Identifies system issues and suggest interventions to the Supervisor to eliminate duplication in services and documents significant variances. Identifies trends/process barriers and participates in development of plans to ensure a method to move patients effectively through the care continuum.
Monitors medical necessity of admissions, continued hospitalization, and surgical procedures using criteria approved by the medical staff and evaluates appropriate level of care for patient and notified the Utilization Review staff of necessary changes.
Utilizes principles of quality improvement in every aspect of performance by participating in unit and organizational quality improvement activities to develop strategies to reduce or resolve variations in practice.
Provides age/developmentally-appropriate patient planning and communication in accordance with Age-Specific Care Guidelines for the specific age groups served.
Maintains working knowledge of payer and reimbursement practices impacting the plan of care. Demonstrates the ability to guide the patient and family through an evaluation of their options for post discharge care.

Benefits

Comprehensive suite of Total Rewards: benefits and well-being programs
Competitive compensation
Generous retirement offerings
Programs that invest in your career development
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program