Position Summary:

The Case Manager is responsible for assessing patient/family psycho-social needs, planning, implementing, procuring services for and evaluating care for patients ranging in age from 18 years to geriatric experiencing medically complex conditions, medical-surgical conditions with rehabilitation and/or wound care needs. Performs concurrent review including admission, continued stay and appropriateness of discharge. Collects information for and as a result of concurrent reviews. Coordinates discharge planning to ensure continuity of care, performing utilization review, and facilitating the patient satisfaction survey process. Participates in functions to coordinate the care of patients with all health team members throughout the facility. Integrates Case Management within the hospital’s primary functions in a manner that contributes to the provision of comprehensive health care and achievement of quality cost effective outcomes.

Minimum Qualifications:

• Ability to project a professional image
• Knowledge of regulatory standards, compliance requirements and hospital policies and procedures
• Working knowledge and ability to apply professional standards of practice in job situations
• Strong organizational, analytical and critical thinking skills
• Working knowledge of computer and software applications used in job functions. (Order entry, data entry)

Education and/or Experience:

• RN Case Manager, preferred
• Graduate from an accredited School of Nursing with BSN preferred, or a LMSW (Licensed Masters Social Worker) or LBSW (Licensed Bachelor Social Worker) as required by the Case Manager’s state in which employed
• Valid Certified Case Manager credential (CCM or ACM ) preferred
• Two (2) years’ experience as a Case Manager in an acute care hospital, but will consider case management health care provider or managed health care company

Certificates, Licenses, Registrations:

RN Case Manager:

• A Registered Nurse who is currently licensed to practice by the state
• CCM credential preferred
• Must maintain current CPR certification throughout employment

LMSW/LBSW Case Manager:

• A licensed Social Worker who is currently licensed to practice by the state in which employed
• Certified Case Manager (CCM) credential preferred
• Must maintain current CPR certification throughout employment

 

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