Case Manager - PRN

ClearSky Health•Cleveland, WI

About The Position

The Case Manager works with physicians and multidisciplinary team members to develop plans of care for assigned patients and monitors their progress toward desired outcomes through assessments and/or patient records. The role identifies and resolves barriers to effective patient care and actively participates in discharge planning. The position integrates company values into daily practice and is PRN. The Case Manager coordinates patient care, supports length-of-stay management, conducts utilization reviews, and communicates with payors regarding timely updates and authorizations. The role documents care coordination, medical necessity, and post-discharge equipment and support needs in the health care record. It also supports compliance with accreditation, state, TJC, and CMS standards and promotes a safe environment for patients, visitors, and staff.

Requirements

Two years of recent relevant experience.
Current state clinical licensure.
Maintain an acceptable driving record, a current driver’s license, and insurability.
Understand treatment costs and financial support as they relate to quality and efficiency.
Demonstrate critical thinking skills, including using logic and reasoning to identify strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
Knowledge of community resources for post-discharge clinical and social needs.
Knowledge of clinical operations and procedures.
Ability to establish and maintain proactive relationships with interdisciplinary team members, insurance companies, physicians, referral sources, community service organizations, and health care facilities.
Ability to maintain quality, safety, and infection-prevention standards.
General computer skills, including data entry, word processing, email, and record management.
Effective organizational and time-management skills.
Effective written and verbal communication skills.
Ability to maintain confidentiality.
Ability to work closely and professionally with others at all levels of the organization.

Nice To Haves

Experience in an acute care setting.
Bachelor’s degree.

Responsibilities

Communicate, collaborate, and coordinate with team members to provide quality patient care and support positive patient outcomes.
Facilitate communication during interdisciplinary team conferences.
Meet accreditation standards and adhere to standards set by the state and accrediting agencies, including TJC and CMS.
Document communication, coordination of patient activities, medical necessity, and post-discharge equipment and support needs in the health care record.
Support and facilitate length-of-stay management.
Conduct utilization reviews.
Communicate appropriate information to payors for timely updates and authorizations, and ensure outcomes are communicated promptly to the clinical team and administration.
Provide an environment conducive to safety for patients, visitors, and staff; assess safety risks and implement appropriate precautions.
Comply with approved safety and infection-prevention standards.
Perform other duties as assigned to support the overall effectiveness of the organization.
Work during inclement weather and other staffing emergencies when required.