Manager Care Management

Franciscan Alliance, Inc.•Munster, IN

3d•Onsite

About The Position

At Franciscan Health, each patient’s hospital stay is as unique as the patient. Care standards, patient needs, and physician orders all come into play in determining a patient’s care plan. At the center of all the assessing, planning, coordinating, and evaluating is our Manager of Case Management. The very best in communicators, these managers work with case managers, physicians, patients, and families to optimize patient care.

Requirements

Bachelor's Degree Nursing - Required
5 years Hospital Nursing/Patient Care - Required
Registered Nurse (RN) - State Licensing Board - Required

Nice To Haves

2 years Case Management /utilization skills - Preferred

Responsibilities

Collaboratively (with the attending physician) determine the severity of illness and level of care which is most appropriate to the treatment needs and financial resources of the patient.
Meet with patient to determine physical needs and capabilities in order to analyze feasibility of treatment goals and potential variances from these goals.
Coordinate treatment plan with patent’s payer source to maximize patient’s coverage.
Identify medical needs and makes appropriate referrals to psychosocial case manager and other disciplines that will make up the patient’s treatment team.
Participate with medical case manager and multidisciplinary treatment team, to individualize each patient’s treatment needs to achieve defined goals for improved patient outcomes.
Collaborate with medical case manager, physicians, and multidisciplinary team to develop and evaluate clinical pathways-standing orders.
In collaboration with psychosocial case manager, assists as a liaison between patient and family members with patient care issues.
Negotiate with patient’s third-party payer regarding non-covered services in an attempt to provide needed services in the most economical means possible.
Support compliance with JCAHO, State, and Federal Agencies for assigned areas.
Promote a professional practice environment supporting all hospital and patient service activities.
Maintain responsibility for inter- and intra-departmental communications, special projects, and services.