What are the responsibilities and job description for the Case Manager - TN - On Site position at Vensure Employer Services?
Position Summary
Utilize clinical expertise and critical thinking skills to work collaboratively with residents, resident family/significant other, healthcare providers, insurers, community resources and other involved parties to develop and implement a plan of care that provides extraordinary care for the patient while being sensitive to costs and resources.
Essential Duties and Responsibilities
Utilize clinical expertise and critical thinking skills to work collaboratively with residents, resident family/significant other, healthcare providers, insurers, community resources and other involved parties to develop and implement a plan of care that provides extraordinary care for the patient while being sensitive to costs and resources.
Essential Duties and Responsibilities
- Communicate regularly with residents and their family about Plans of Care, PT, OT and other treatment protocols.
- Attends and participates in morning meetings/stand up to facilitate communications with the team.
- Answer residents' questions about their care, treatment plans, illness progression and all other issues so they feel safe and secure in our care.
- Monitor and adjust resident's statuses based on changing needs and conditions.
- Organize and prioritize daily work by assessing new, current and discharging residents needs in area(s) of responsibility.
- Complete documentation as required.
- Performs utilization review activities to provide resident appropriate, timely and cost-effective care.
- Coordinate care with resident, care providers, facilities financial services, and third-party payers.
- Oversee all admissions and discharge activities.
- Coordinate referrals both to and from our facility.
- Ability to relate positively, effectively, and appropriately with residents, families, staff and professional colleagues.
- Accurate charting and ability to complete necessary paperwork in a timely manner.
- Ability to work independently and exercise sound judgement in interactions with physicians, providers, payers and residents and their families.
- Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including residents/families/caretakers, physicians, nurse and other ancillary partners.
- Must have excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.
- Intermediate computer skills.
- Competence maintaining professional, respectful, honest interactions with residents/families and staff and partners.
Knowledge, Skills and Abilities
- Ability to read technical procedures.
- Ability to read and comprehend policy and procedure manuals.
- Ability to effectively present information and respond to questions from managers and employees.
- Ability to apply concepts such as fractions, percentages, ratios and proportions to practical situations.
- Ability to solve practical problems.
- Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
- The essential functions of this position require the following physical abilities:
- Standing and /or walking very frequently.
- Sitting occasionally.
- Reaching with hands and arms frequently, pushing/pulling very frequently.
- Talking and /or hearing very frequently.
- Tasting and /or smelling very frequently.
- Lifting up to 50 pounds frequently.
- Climbing, balancing, stooping, kneeling, crouching or crawling occasionally.
- Close, distance, color, peripheral, and depth perception in vision: ability to adjust focus.
Education & Experience
- Bachelor's Degree in Nursing or Social Work.
- Registered Nurse (RN) license preferred.
- Licensed (LVN or LPN) nurse acceptable.
- Two (2) year clinical nursing experience preferred.
- Knowledge of Medicare, Medi-cal and Medicaid programs and benefits.
- PCC Knowledge
- LVN/LPN Valid License or RN Valid Licensee in the state you are working.
- Certificate as a certified Case Manager (CCM) a plus.
- Must maintain all required continuing education/licensing.
- Must remain in good standing with the Department of Public Health.
- License and Certification Division at all times.
