Case Manager PRN
About The Position
The Case Manager coordinates and facilitates care for patients through collaboration and communication with the Interdisciplinary Care Transitions (ICT) team. The role follows patients across the continuum of care and supports appropriate resource utilization, service delivery, and compliance with external review agencies. It provides ongoing expertise through comprehensive assessment, care planning, plan implementation, and evaluation of individual patient needs. The position integrates case management, utilization review and management, and discharge planning to improve the quality of patient management and satisfaction, promote continuity of care, and support cost effectiveness. The Case Manager works with interdisciplinary teams and physicians, advocates for patients, and refers high-risk patients for additional support.
Requirements
- Graduate of an accredited LPN/LVN or RN program, or a Master of Social Work with licensure as required by state regulations, or a Bachelor of Social Work with licensure as required by state regulations.
- Healthcare professional licensure as an 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.
- Knowledge of government and non-government payer practices, regulations, standards, and reimbursement.
- Knowledge of Medicare benefits, insurance processes, and contracts.
- Knowledge of accreditation standards and compliance requirements.
- Fluent in reading, writing, and speaking English.
- Basic computer skills, including working knowledge of Microsoft Office, word-processing, and spreadsheet software.
- Excellent interpersonal, verbal, and written communication skills to obtain cooperation and collaboration from hospital leadership, physicians, payors, and other external customers.
- Good interpersonal skills when working or interacting with patients, their families, and other staff members.
- Regular attendance.
Nice To Haves
- Experience in case management, utilization review, or discharge planning.
Responsibilities
- Coordinate clinical and/or psychosocial activities with the Interdisciplinary Team and physicians.
- Support effective care coordination and efficient care facilitation.
- Stay current on reimbursement modalities, community resources, case management, and psychosocial and legal issues affecting patients and care providers.
- Refer high-risk patients who would benefit from additional support.
- Serve as a patient advocate.
- Apply knowledge of growth and development across the lifespan to provide age-appropriate care to the patient population served.
- Participate in interdisciplinary patient care rounds and/or conferences.
- Collaborate with clinical staff to execute the plan of care and achieve goals.
- Perform other related duties as assigned.
