What are the responsibilities and job description for the Case Manager position at Arkansas Children's?
ARKANSAS CHILDREN'S IS A TOBACCO FREE WORKPLACE. FLU VACCINES ARE REQUIRED. ARKANSAS CHILDREN'S IS AN EQUAL OPPORTUNITY EMPLOYER. ALL QUALIFIED APPLICANTS WILL RECEIVE CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, GENDER IDENTITY OR EXPRESSION, NATIONAL ORIGIN, AGE, DISABILITY, PROTECTED VETERAN STATUS OR ANY OTHER CHARACTERISTIC PROTECTED BY FEDERAL, STATE, OR LOCAL LAWS.
CURRENT EMPLOYEES : Please apply via the internal career site by logging into your Workday Account (https : / / www.myworkday.com / archildrens / )and search the "Find Jobs" report.
Work Shift : Day Shift
Time Type : Full time
Department :
CC017640 Case Management
Summary :
The Case Manager reviews medical records of inpatients to determine medical necessity for hospitalization and obtains authorization from payor sources. Coordinates the integration of social services / case management function into the patient care, discharge and home planning processes with other hospital departments, external service organizations, agencies and healthcare facilities.
Additional Information :
Required Education :
Associate's degree or equivalent from two-year college program or technical school or nursing diploma, Associate's Degree or Equivalent or Nursing Diploma, Associate Degree Nursing
Recommended Education :
Bachelor's Degree, Bachelor's Degree Nursing, Bachelor's Degree or Equivalent or Nursing Diploma, Master's degree or equivalent degree
Required Work Experience :
Nursing - 3 years of experience
Recommended Work Experience :
Required Certifications :
Accredited Case Manager (ACM) - American Case Management Association, Certified Case Manager (CCM) - The Commission on Case Manager Certification, Must obtain ACM certification within 1 year of eligibility - Accredited Case Manager - ACM, Must obtain CCM certification within 1 year of eligibility - Certified Case Manager - CCM, Or - , RN License (AR or Compact State) - Arkansas State Board of Nursing (ASBN)
Recommended Certifications :
Description
1. Completes assessment of patient and family needs at time of admission and ongoing review through expected hospital course. Evaluates medical necessity of inpatient hospitalization, coordinating communication to payers and key hospital stakeholders, patient and family. Coordinates and collaborates with LIPs and clinical staff on discharge plan of care.
2. Promotes and advocates for Patient and Family Centered care through collaboration with LIPs, clinical staff, the patient and family to ensure a safe discharge.
3. Monitors patient's clinical progress and identifies potential discharge needs and community resources early in the hospitalization. Provides oversight to ensure that care is coordinated and complete and ensures a timely discharge.
4. Coordinates communication with 3rd party payors, medical staff, families, and patients, the plan of care, length of stay, continued stay certification, home care arrangements and other utilization issues to ensure appropriate reimbursement.
5. Communicates with physicians at regular intervals throughout hospitalization and develops an effective relationship.
6. Completes written documentation regarding assessment, problem identification & desired outcomes, planning, implementation, and evaluation. Provides verbal reports to assure continuity of care and achieve desired patient outcomes for discharge.
7. May complete referrals to community resource agencies for patients with home discharge needs, documenting agencies who will be providing services in the patients medical records. Provides follow-up phone calls within 72 hours of discharge.
8. Promotes exceptional customer service and supports the AC's philosophy of Family Centered Care.
9. Performs other duties as assigned.
