CASE MANAGER

BEYOND HEALTH MANAGEMENT SOLUTIONS•McKinney, TX

11d•Onsite

About The Position

Responsibility to coordinate clinically complex patients care across a continuum; ensuring and facilitating the achievement of quality clinical and cost outcomes, negotiating, procuring and coordinating appropriate services and resources needed by the patients, and at key points, intervening to address and resolve issues/concerns. Key in ensuring appropriate sequencing of treatment goals and implementation of a comprehensive discharge plan. Demonstrate knowledge and skills necessary to provide case management services to the patient population experiencing rehabilitation needs.

Requirements

Current, valid, and active license in the state of employment as a Registered Nurse (RN), Licensed Social Worker (LSW) required.
Current BLS certification required.
Working knowledge and ability to apply professional standards of practice in job situations.
Must be assertive and personable with the ability to balance the complex challenge of delivering quality, cost- appropriate, and service-oriented outcomes.
Demonstrates comprehensive knowledge of the principles and concepts of case management and applicable standards of voluntary and regulatory agencies for review activities.
Proficient in collecting and retrieving material from medical records.
Knowledgeable in utilization review, medical terminology, appropriate levels of care, treatment, modalities, statues, and healthcare delivery models.
Communication skills, both written and oral, must be outstanding and practiced with all internal and external business relationships.
Interpersonal relationship abilities must be highly refined with negotiation and problem solving skills at a very high level.
Must possess strong clinical assessment and process skills.
Critical thinking skills must be demonstrated in all situations.
Ability to project a professional image.
Knowledge of regulatory standards and compliance requirements.
Strong organizational, prioritizing and analytical skills.
Ability to make independent decisions when circumstances warrant.
Working knowledge of computer and software applications used in job functions.
Freedom from illegal use of and effects of use of drugs and alcohol in the workplace.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions and decimals.
Ability to compute rate, ratio, and percent.
Ability to apply common sense understanding to carry out instruction furnished in written, oral and/or diagram form.
Ability to define and solve problems and collect data.
Ability to identify and implement components of the Case Management process.
Identify learning needs and teach patients and families.
Ability to communicate and collaborate with a variety of teams and individuals.
English is the primary language of the facility.
Ability to read and write, communicate clearly with co-workers and customers and to respond to appropriate questions regarding work process or work product.

Nice To Haves

Minimum one (1) year of case management experience preferred.
Previous LTAC experience preferred.
CCM or ACM certification preferred.

Responsibilities

Coordinate clinically complex patients care across a continuum.
Ensure and facilitate the achievement of quality clinical and cost outcomes.
Negotiate, procure and coordinate appropriate services and resources needed by the patients.
Intervene to address and resolve issues/concerns.
Ensure appropriate sequencing of treatment goals and implementation of a comprehensive discharge plan.
Provide case management services to the patient population experiencing rehabilitation needs.
Maintain excellent working relationships with co-workers, health care professionals and other health related facilities and organizations as appropriate.
Promote Organization philosophy, mission and objectives within and to patients and customers outside the hospital.
Demonstrate ability to prioritize tasks/responsibilities and complete duties within allotted time.
Seek out new methods and principles and be willing to incorporate them into existing practices.
Demonstrate and understand the importance of and respect for the rights, dignity, and individuality of each patient in all interactions.
Demonstrate honesty and integrity at all times in the care and use of patient and hospital property.
Demonstrate respect for co-workers and responds to needs of patients by complying with hospital policies.
Demonstrate satisfactory level of interpersonal skills to interact and deal tactfully with facility staff, Administration, patients, families, customers, vendors, and government agencies.
Access continuing education opportunities appropriate to responsibilities.
Appropriately access the resources of the company's corporate offices for consultation and support.
Routinely share professional knowledge with staff, managers and hospital personnel.
Attend and participate in facility meetings.
Knowledge of emergency and disaster procedures of the facility.
Participate in hospital wide safety program identifying risks to patient safety and reducing healthcare errors.
Participate in relevant in-service training sessions.
Review patients charges.
Perform other duties as assigned.
Promotes and protects patients rights; treats patients with dignity and respect; reports suspected abuse or neglect.
Demonstrates willingness to try new tasks; generates new ideas for change; evaluates and recognizes priorities; communicates and models organizational values; fosters high performance.
Applies performance improvement methods and techniques; assists in data collection; identifies processes for improvement in daily work; and participates in new employee orientation.
Demonstrates understanding of fire and emergency procedures; participates in fire and disaster drills; demonstrates understanding of safety and security procedures; applies safety and security precautions; demonstrates understanding of hazardous materials plan; demonstrates proper use of equipment.
Applies hand-washing principles during daily work; demonstrates understanding of isolation precautions; recognizes signs and symptoms of infection and complies with the employee health program; demonstrates understanding of the process for identifying and handling infectious waste; maintains personal hygiene; complies with OSHA standards in the work place; and demonstrates understanding of cross-contamination.
Complies with applicable health screenings.
Enters or records data timely and accurately; protects confidentiality of patient information; protects data against loss or destruction; reports suspected violation of security/confidentiality issues.
Demonstrates active listening techniques; gains support through effective relationships; treats others with dignity and respect; seeks feedback; participates in processes to measure effectiveness, efficiency, and service; and maintains reporting mechanisms.
Attends in-service and education programs; attends continuing education required for maintenance of certification.