Description

SUMMARY:

The Case Manager  (RN) is a key member of the interdisciplinary team and is responsible for assessment of patient/family psycho-social needs, planning, implementing, procuring services for and evaluating outcomes for patients ranging in age from 18 years to geriatric experiencing medically complex conditions, and/or medical-surgical conditions with rehabilitation and medical needs. Responsibilities include being a patient advocate, providing psycho-social assessment, discharge planning, effective services coordination along the continuum of care and counseling to patients and families. The Case Manager oversees the healthcare delivery and helps facilitate interdisciplinary team decisions. The Case Manager assures that regulations regarding patients’ rights are fulfilled. The Case Manager will strive for comprehensive health care and achievement of quality cost effective outcomes.
 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

            May include, but is not limited to the following:

To perform this job successfully, an individual must be able to perform each key function satisfactorily.  Reasonable accommodations may be made to enable individuals with disabilities to perform the key functions.

Job Specific:

• Evaluate patients’ psycho-social needs and the impact of illness on those needs.
• Evaluate patients’ family/social situation to support a medical treatment plan.
• Make recommendations to the healthcare team for appropriate psycho-social.
• Utilize community resources to assist patients’ psycho-social needs.
• Document history, care plans and prepares reports as needed.
• Be the "go to person" for the patient and family during their stay.
• Document communication with patients, families, and physicians.
• Must be able to articulate effectively to family and patients and team members.
• Must use a team approach.

Operations and Support Services:

• Demonstrates satisfactory level of interpersonal skills to interact with facility staff, Administration, patients, families, customers, vendors, and government agencies.
• Demonstrates and understands the importance of and respect for the rights, dignity, and individuality of each patient in all interactions.
• Demonstrates honesty and integrity at all times in the care and use of patient and hospital property.
• Knowledge of emergency and disaster procedures of the facility.
• Demonstrates respect for co-workers and responds to needs of patients by complying with hospital policies.
• Demonstrates ability to prioritize tasks/responsibilities and complete duties within allotted time.
• Appropriately accesses the resources of the company’s regional offices for consultation and program development support. Seeks out external resources through conferences, workshops, etc. as necessary.  Routinely shares professional knowledge with staff, managers and hospital personnel.
• Ability to carry out the essential functions of this job (with or without reasonable accommodation).
• Assure participation in relevant in-service training sessions.
• Attend and participate in facility meetings as required.
• Access continuing education opportunities appropriate to responsibilities.
• Participate in hospital wide patient safety program identifying risks to patient safety and reducing healthcare errors.
• Performs other duties as assigned.

Qualifications

Education

Graduate from a school of Social Work or Nursing.

License/Certification

Current license for the discipline of degree for the state of practice. 

Current Basic Life Support (BLS) CPR certification through the American Heart Association. 

Both license and certifications must be maintained throughout employment.

Experience

(2) Years’ experience as a case manager in a health care setting preferred.

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 and analytical skills. 

Working knowledge of computer and software applications used in job functions (order entry, data entry).

SUPERVISORY RESPONSIBILITIES:

N/A

OTHER REQUIREMENTS:

Participates in or conducts company-wide sponsored training to safeguard against improper use and disclosure of patient’s protected health information.  Monitors and ensures compliance with company policies, procedures, state and federal regulations and Accreditation Standards.

Company Specific

• Adheres to dress code, appearance is neat and clean and wears appropriate identification while on duty.
• Adheres to all smoking or tobacco regulations established by corporate building owners, state, or federal laws.
• Completes annual health, safety, and education requirements.  Maintains professional growth and development.
• Maintains confidentiality of all patient and/or employee information to assure patient and/or employee rights are protected.
• Demonstrates knowledge of the principles of growth and development and the skills necessary to provide age appropriate care to the patient population served.
• Reports to work on time as scheduled; adheres to policies regarding notification of absence.
• Attends all mandatory in-services and staff meetings.
• Represents the organization in a positive and professional manner.
• Complies with all organizational policies regarding ethical business practices.
• Communicates the mission, ethics, and goals of the hospital, as well as the focus statement of the department.
• Maintains current licensure/certification for position, if applicable.
• Consistently demonstrates superior customer service skills to patients, physicians, visitors, employees, and any other individuals with whom they may come in contact.

• Consistently follows departmental and hospital Health, Safety, Security, Hazardous Materials policies and procedures.
• HIPAA: Conduct job responsibilities in accordance with HIPAA privacy laws, follow hospital policy in provision of patient confidentiality. Able to identify patient confidentiality issues and reports to proper hospital personnel immediately.

• Compliance: Conducts job responsibilities in accordance with standards set forth in Code of Conduct, policy and procedures, applicable federal and state laws, and applicable standards.

Core Values:

Professionalism –To always maintain the highest standard and regard for others.  Keep skills, competencies and required licensures/certifications current; displays mastery over attitude and behavior and pride in appearance. Consistently performs duties to the best of abilities.

Exceptional Care—Go above and beyond expectations by providing exceptional care to WOW our customers—patients, family, physicians, and each other.

Respect – Treating others as they would like to be treated; valuing others. Acknowledges the worth of others through professional greetings, proper telephone etiquette, patience, and common courtesy.

Fun - Having fun and celebrating small successes in our journey to achieve big.  Always demonstrates a positive attitude toward work and devotion to our passion and task at hand.

Teamwork –To function as a unit, with common goals, recognizing we can achieve far more as a team than as individuals.  Cooperates with co-workers while performing duties leading to everyone being able to achieve success and giving recognition where it is due.

Integrity – To always be honest and trustworthy in all our relationships.  Demonstrates adherence to a strict moral or ethical code in performance of duties by always seeking to do the right thing.

Accountability -- Responsibility of our actions that influence the lives of our customers and fellow workers.  Takes ownership of all aspects of duties shown through reliable, timely performance and responsibility.

Responsibility – Maintains accountability by doing what is expected or beyond; assuring the appropriate tasks and project items are completed. Takes ownership of all aspects of duties shown through reliable, timely performance and accountability.

Knowledge/Skills/Abilities:

• Ability to function independently in all aspects, including project identification, evaluation, contract negotiations, and coordination with management and internal departments.
• Ability to represent the company in a confident, persuasive and positive manner.
• Good interpersonal, verbal and written communication skills.
• Ability to work under stress and respond quickly in emergency situations.