Complex Case Manager Care Coordination

Banner Health•Lawrenceville, IL

1d•$36 - $60

About The Position

This position provides comprehensive care coordination for assigned patients, with the intensity of services adjusted to patient needs and payer requirements. The role is accountable for the clinical quality of care coordination, identifies and resolves barriers to effective care, and empowers patients and families to participate in discharge planning. It provides developmentally appropriate care for patients of all ages, including those who are physically disabled, mentally ill, chronically ill, or terminally ill, with a focus on safe discharge and continuity of care. The role manages complex cases in a fast-paced hospital environment, develops discharge plans, collaborates with physicians and hospital leadership, and serves as a resource to peers. It also provides leadership in process improvement and interdisciplinary discharge planning, communicates plans across the continuum of care, and educates the health care team on case management and managed care concepts. The position has substantial autonomy and reports directly to the Associate Director, according to the job posting.

Requirements

For RN applicants: knowledge of case management or utilization review normally obtained through completion of a bachelor's degree in case management or health care.
For RN applicants: current Registered Nurse (R.N.) license in the state worked.
For Social Worker applicants: Master's Degree in Social Work.
For Social Worker applicants: Licensed Master Social Worker (LMSW) or Licensed Clinical Social Worker (LCSW), or an MSW with the requirement to become licensed within 6 months of hire; an equivalent license applies where the state does not recognize an LMSW.
Basic Life Support (BLS) certification is required for assignments in an acute care setting.
Typically requires 2 years of clinical experience.
Demonstrated critical-thinking, problem-solving, effective communication, and time-management skills.
Ability to work effectively in an interdisciplinary team format.
May need to take rotating call based on acute facility needs.
Banner Registry and Travel positions in acute facilities require at least 1 year of Case Manager experience in an acute care hospital.
Acute hospital case management experience is sought for this role.

Nice To Haves

Certified Case Manager (CCM) certification.
Additional related education and/or experience.

Responsibilities

Manage individual patients across the health care continuum to achieve optimal clinical care, financial, operational, and satisfaction outcomes.
Manage a caseload of 20–25 patients with complex medical and psychosocial needs.
Develop discharge plans for challenging hospital cases and plan for safe discharge and continuity of care.
Lead process improvement activities for patient populations.
Collaboratively develop and manage interdisciplinary patient discharge plans and communicate plans across the continuum of care.
Identify and resolve barriers that may hinder effective patient care.
Maintain knowledge of Medicare, Medicaid, and other program benefits to assist patients with discharge planning and choices.
Use knowledge of community resources relevant to health care, end-of-life dynamics, substance abuse, abuse, neglect, and domestic violence.
Establish and promote collaborative relationships with physicians, payers, and other members of the health care team.
Collect and communicate pertinent, timely information to payers and others to fulfill utilization and regulatory requirements.
Educate internal health care team members on case management and managed care concepts and facilitate their integration into daily practice.
Serve as a resource to peers on discharge planning.
Collaborate with physician and hospital leadership to drive results.
May supervise other staff.