Case Manager Jobs

About The Position

Requirements

• Current ASW, AMFT license
• Current BLS provider card
• Masters degree SW or MFT OR Diploma RN or BSN degree
• Two years as a Case Manager in an acute care setting OR five years recent acute care nursing experience
• Strong interpersonal skills
• Leadership skills
• Negotiation skills
• Good leadership talent
• Knowledge of hospital operations
• General knowledge of the payer industry, resource management, reimbursement, and evidence-based clinical practice
• Ability to develop, maintain, and model professional, objective and value-oriented interpersonal skills
• Ability to continuously promote a patient-centered philosophy
• Ability to maintain positive and proactive communication with patients, families, staff members, and physicians
• Ability to foster team-building relationships
• Excellent organizational skills
• Ability to problem solve

Responsibilities

• Case management across the continuum of care utilizing an interdisciplinary approach to managing patient throughput in a fiscally responsible manner to achieve optimal outcomes
• Coordination of care
• Utilization review
• Acting as a resource to patients, family and/or significant others and staff
• Referrals to clinical social worker for psycho-social issues and complicated discharge planning issues
• Overseeing coordination of post-hospital care needs
• Interacting with insurance companies, medical groups, and community resources to ensure timely, efficient use of all services
• Applying knowledge of the expected clinical process, available resources, medical necessity criteria, regulatory requirements, and relevant standards of care in anticipating patient needs