Job description
RN/LMSW Case Manager: is responsible for the delivery of comprehensive care to a set of assigned patients at a specific point in time. This involves the assessment of patient and care team needs and the development, implementation and evaluation of an appropriate Plan of Care, making changes in response to changing patient needs.
RN/LMSW Case Manager: guides the utilization review process using recognized standards of care to assure appropriate medical necessity, level of care, patient status and related notifications are met.
RN/LMSW Case Manager: guides patient progression across the care continuum to ensure safe and timely transitions to the appropriate level of care.
Roles and Responsibilities:
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Evaluates hospital admissions using evidence-based standards of care to assure care is medically necessary and delivered at the most appropriate level of care.
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Communicates effectively with providers and care teams to ensure medical necessity and patient status are appropriately captures and documented.
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Actively participates in multidisciplinary rounds as available.
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Issues federal and state notices as indicated.
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Serves as discharge planner for patients as assigned.
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Assess patient risk for readmission, ability to self-manage and identifies community support systems as appropriate.
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Ensures patient demographics, insurance, primary care provider, and advanced directives are up to date in EMR.
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Facilitates referrals to support teams and community-based organizations.
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Works to identify and eliminate barriers to discharge.
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Is flexible in assuming other responsibilities not noted above.
Required Skills and Experience:
Education - Graduation from accredited Nursing or Masters of Social Work program.
Expected to complete Case Management Certification - or equivalent - within 18 months of hire
Experience - Minimum 2 to 3 years' experience in an acute care hospital setting or similar health care case experience.
Knowledge of community-based organizations and strong communication, organizational, critical thinking and problem solving skills required.
Computer literacy and knowledge of EMR systems.
Demonstrates resilience in coping with challenging situations as well as the emotional stability and organizational skills necessary to meet the demands of the busy healthcare environment.
Licensure - current unrestricted NY State Licensure RN/ LMSW
Preferred Skills and Experience:
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BSN in nursing preferred
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Case Management Certification preferred
Physical Requirements:
- Ability to stand, sit or ambulate for long periods. Ability to mobilize freely around units, transport self to site locations, and perform required data entry into EMR and alternate data management systems.
Location and Travel Requirements:
- Onsite
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