Case Manager - Care Coordination - Days - FT

Coordinates the efforts of patient, family, and healthcare professionals to develop a plan of care across the continuum based on identified needs. Reviews and assesses the appropriateness of patient admissions and continued stays in accordance with established policies and procedures. Ensures implementation of the prescribed plan of care in collaboration with patient/family and healthcare providers.

Coordinates care and services across the continuum working directly with patient/ family, healthcare providers, staff, and payers. Evaluates and communicates patient progress towards established outcomes. Coordinates multi-disciplinary discharge planning to assess current and discharge needs. Evaluates patient satisfaction and quality of care provided.

Provide post-discharge follow-up to ensure the progress of the discharge plan. Promotes quality and cost-effective interventions, resources, and outcomes utilizing a multidisciplinary team approach. Reviews and determines necessity and appropriateness of hospitalization using established criteria to prevent denials of payment.

Refers appropriate cases to the physician advisor for intervention. Serves as a liaison with healthcare providers, admissions, and medical records staff to assure continuity of patient care, discharge planning, and effective communications. Arranges appropriate referrals for counseling, financial assistance, and discharge planning assistance as needed.

Assists in the collection, delivery, and tracking of information for Performance Improvement, Risk Management, and Infection Control.

Education

Associate's Degree Bachelor's Degree Graduate of an accredited program in nursing Bachelor of Science in Nursing (BSN) Experience: 3 Clinical experience as a registered nurse in an acute care facility Advanced quality management, utilization management, case management and/or DRG documentation compliance principles Skills: Excellent customer service and communication skills Strong organizational and problem-solving skills Advanced statistical and spreadsheet/database application skills