Clinical Case Manager

County of DuPage•Wheaton, IL

2d•Onsite

About The Position

This position will provide professional clinical case management to patients and clients coordinating services, treatment status, discharge plans and communicating benefits and financial information.

Requirements

Completion of a Bachelor’s degree in Social Work, Psychology, or a related human service field
One (1) to two (2) years of experience within a skilled nursing facility working with Medicare/Medicaid populations
Post-offer physical is required.
A pre-employment background check is required.

Responsibilities

Reviews, assesses and documents benefit, medical, social and financial information in an accurate and appropriate manner.
Establishes contacts with family, payer and other internal and external customers.
Develops and works with the interdisciplinary team to coordinate a safe, effective, realistic and timely discharge plan and coordinates services and equipment needed for patients discharge.
Develops and maintains current documentation in the medical records regarding status of discharge plans, case management authorizations and utilization review related to discharge.
Conducts Minimal Data Set (MDS) interviews and completes assigned sections of MDS 3.0 including assigned Care Area Assessments (CAA)
Works with the Interdisciplinary team to create a plan of care.
Initiates contact with incoming long-term resident/patients and/or their initial contacts to have a dialogue about their transition from the community into a skilled nursing a facility.
Provides ongoing support and advocacy for the resident and acts as a liaison to family.
Completes initial assessments including social history, social services assessment and trauma informed care.
Schedules and Coordinates care plan meetings.
Obtains and documents authorizations for continued stay, procedures and tests ordered as medically necessary, per payer requirements.
Coordinates completion of letters of medical necessity.
Coordinates and facilitates interdisciplinary meetings.
Assists in facilitating a smooth transition to alternative levels of care or discharge destinations.
Assists in coordinating and facilitating patient/resident transitions within the Care Center to ensure continuity of care.
Acts as a patient advocate utilizing internal or community resources to meet the residents medical, social or financial needs for discharge as well as for long term care patients.
Conducts resident interviews for investigations.