Case Manager

Role/Position Definition: Ensures that an individualized care plan and program is developed and implemented for patients and their family during their hospital stay and after discharge from facility. Confirms safe and effective care prior to admission and through discharge for all patients.

Qualifications/Position Requirements:

Education/Experience

• Bachelor’s or master’s degree in psychology or human services required.
• 3-5 years of clinical experience, preferably in case management, or related experience

Licensure/Certification

• Certified Case Manager (CCM) preferred.

Knowledge, Skills and Abilities

• Must possess excellent written and verbal communication skills.
• Ability to exercise professional judgment and initiative when analyzing problems and recommending solutions.
• Knowledge of state and federal regulations regarding patient care, case management and discharge planning.
• Knowledge of insurance.
• Basic computer skills, including use of Microsoft Office software.
• Able to multitask and be flexible in a fast-paced environment.

Work Environment:

Definitions: Occasionally = .25 – 2.5 hours/day

Frequently = 2.5 – 5.5 hours/day

Continuously = 5.5 – 8 hours/day

• Sitting – Frequently.
• Standing – Frequently.
• Walking – Frequently.
• Lifting/Carrying 0-10lbs – Occasionally.
• Lifting/Carrying 10-20lbs – Occasionally.
• Lifting/Carrying 20-50lbs – Occasionally.
• Lifting/Carrying 50-100lbs – Never.
• Lifting/Carrying over 100lbs – Never.
• Reach Above – Occasionally.
• Bend/Stoop – Occasionally.
• Use hands for pushing/pulling – Occasionally.
• Use hands for fine manipulation – Frequently.
• Travel – May travel to locations throughout the organization – Never.
• Public Contact – Interaction with public in person and over phone - Frequently.
• Blood/Body Fluid – Exposure to blood/body fluid - Occasionally.
• Chemicals – Rare
• Computer – Seated use of computer, typing & viewing - Continuously.

Duties and Responsibilities:

• Reviews medical records for potential admissions and assist with admission process. May include verifying insurance and patient assessment based on information provided ensuring safe and effective care within our facility.

• Assessing clients’ physical and mental wellness, needs, preferences and abilities and using these to develop tailored care plans.
• Working with clients, family and support networks and health care professionals to put care plans in place.
• Recording clients’ progress in EMR.
• Evaluating clients’ progress periodically and adjusting as needed to improve outcomes.

• Maintain communication with pending patients, their families, and referral sources and routinely follow the progress of prospective patients.
• Coordinate services and/or equipment with contracted vendors.
• Conducts evaluations to determine the patient’s discharge plan, discharge needs, emotional and social needs.
• Encourage and enhance patient, family, and other necessary agents in the involvement in the treatment and disposition of planning.
• Facilitate post-dispositional adjustment of the patient and family.
• Enhance understanding and adjustment to the patient’s disability by providing support, education, and training.
• Assist with arranging post-discharge services.
• Communicate with the clinical staff as needed for clarification of the patient’s status and update them on the discharge plan.
• Provides documentation in a legible manner to maintain the quality of the medical record as it relates to reimbursement guidelines, accuracy, and facility requirements.
• Participates in team and family conferences as necessary.
• Promotes current standards of clinical practice through participation in continuing education and in-service programs.
• Participates in program development.
• Provides in-services to other staff members as required, regarding case management.

• Following up with discharged clients to ensure they were satisfied with services and they are still in good physical and mental health.

• Performs all other duties as assigned.