Case Manager PRN
About The Position
The Case Manager works with physicians and multidisciplinary team members to develop plans of care for assigned patients, monitors patients’ progress toward desired outcomes through assessments and/or patient records, identifies and resolves barriers to effective patient care, and participates in discharge planning. The position integrates company values into daily practice. This is a PRN position providing as-needed support to full-time staff, including holiday and PTO coverage and additional staffing based on patient-care and operational needs. The Case Manager collaborates with the care team, supports length-of-stay management, conducts utilization reviews, coordinates with payors, and helps ensure compliance with applicable accreditation and safety standards.
Requirements
- Relevant bachelor’s degree, current state clinical licensure, or four years of relevant experience.
- Clinical licensure when required by the state.
- Maintain an acceptable driving record, a current driver’s license, and insurability.
- Demonstrate understanding of treatment costs and financial support in relation to quality and efficiency.
- Use critical thinking, logic, and reasoning to assess alternative solutions, conclusions, and 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 people at all organizational levels.
- Significant standing and walking during a shift.
- Ability to lift or exert up to 25 pounds.
- Possible exposure to bodily fluids.
- Visual acuity for patient assessment and documentation; acute hearing for accurate patient assessment; sufficient manual dexterity to operate equipment and a computer keyboard; close vision and ability to adjust focus.
Nice To Haves
- Experience in an acute care setting is preferred.
Responsibilities
- Communicate, collaborate, and coordinate with team members to provide quality patient care and support positive patient outcomes.
- Facilitate communication during interdisciplinary team conferences.
- Follow accreditation standards and standards established by the state, The Joint Commission (TJC), and the Centers for Medicare & Medicaid Services (CMS).
- Document communications, coordination, patient activities, medical necessity, and post-discharge equipment and support needs in the health care record.
- Support and facilitate length-of-stay management and conduct utilization reviews.
- Communicate appropriate information to payors for timely updates and authorizations, and ensure the information’s outcome is communicated promptly to the clinical team and administration.
- Work during inclement weather and other staffing emergencies when required.
- Provide a safe environment for patients, visitors, and staff; assess safety risks and implement precautions.
- Comply with applicable safety and infection-prevention standards.
- Perform other duties as assigned to support organizational effectiveness.
