This role plans and prioritizes care for individuals and populations of patients, focusing on strategies that promote optimal health. The Case Manager demonstrates expertise and current knowledge in nursing care and management of a caseload of patients of varying complexity. They seek to improve patient, family, and health systems/community outcomes through the application of educational concepts/skills and preventive care in a managed care environment. The position involves assessing internal and external referrals to identify patient/significant others’ needs, level of intensity, insurance benefits, and other patient resources. A plan of care is developed, with recommendations made to PCPs, specialists, and other members of the health care team regarding care management strategies, identifying ways to maximize continuity of care across the continuum. The role also involves assessing the educational needs of patients, families, and health care team members, and developing/implementing appropriate teaching strategies or making referrals. Communication and collaboration with patients/significant others/providers/payers are key to coordinating services that improve access to appropriate services across the continuum of care and promote optimal health in a cost-effective manner. Patient care outcomes are measured, reports are interpreted, and data trends are analyzed for groups of patients. Patient data, plans, interventions, and outcomes are documented according to department guidelines.
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Job Type
Full-time
Career Level
Mid Level