Care Management Specialist

Job Summary

Under the direction of a licensed professional, coordinates and implements identified discharge plans for inpatient and outpatient services. Communicates and collaborates with the interdisciplinary team through verbal and written communication. Responsible for coordinating the transition of care as described in the individualized discharge plan. Adheres to confidentiality policies specific to communication, record keeping, and coordination of services. Responsible for documentation in all areas of discharge planning. Care Management Specialists provide assistance to patients, families, and/or significant others as well as internal members of the interdisciplinary team. Facilitates assistance with referrals to appropriate post-acute services and other community resources. Helps obtain insurance authorization daily. Provides patient choice and important message from Medicare letters as required. Demonstrates a working understanding of federal and state regulations, departmental policies, particularly those related to discharge planning. Arranges transportation as appropriate for transition of care. Case Management Specialists seek guidance from assigned RN Case Manager and/or Social Worker as needed.

Essential Functions

• Demonstrates ability to prioritize tasks for completion.
• Carries out job duties in a way that is most productive and efficient.
• Deals with job stress effectively by continuing to be productive during peak work-load situations.
• Demonstrates a positive "can do" attitude about all duties performed.
• Work is accurate and complete; maintains a clean, organized, safe work area.
• Demonstrates knowledge, understanding and application of policies and procedures in performing job functions.
• Demonstrates sound judgment in handling situations not covered by written or verbal instructions.
• Open to change; manages change positively, willingly evaluates and adapts actions as the hospital environment changes, willing to take on new work routines and methods.
• Functions as a team member, exhibiting sensitivity, fairness, trust, respect, and willingness to balance personal needs with group needs.
• Communication is clear and concise, FREE OF GOSSIP, confidential, and courteous. Listens actively. Limits social conversations in the workplace.
• Adheres to strictest confidentiality in dealing with patients, families, hospital personnel and the public.
• Actively supports administrative and supervisory decisions.
• Is able to work independently.
• Recognizes duties to be performed although not directly assigned.
• Identifies job-related and personal areas for learning, assumes responsibility for continuing education requirements. If applicable, learns new procedures and protocols.
• Assists during crisis situations, helping hospital staff medical staff, families and patients when situations become a crisis.
• Ensures the delivery of quality social services to clients and outpatients by identifying client needs and networking with community resources to meet those needs.
• Acts as a liaison with the nursing/medical staff and community agencies to facilitate problem solving and coordinating services.
• Attends meetings as required and participates on committees as directed.
• Coordinates services with providers and third party payors
• Performs other duties as assigned.
• Complies with all policies and standards.

Qualifications

• H.S. Diploma or GED required
• 1-2 years Minimum of 1 year previous healthcare experience with knowledge of patient discharge planning procedures required

Knowledge, Skills and Abilities

• Excellent communication and interpersonal skills.
• Ability to find and print Patient Family Education Documents
• Ability to triage immediate member health and safety risks
• Strong written and verbal communication skills
• Communication skills
• Work in multiple systems simultaneously
• Must possess critical thinking skills