RN Case Manager

Case Manager

We're unique. You should be, too. We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?

We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.

ESSENTIAL JOB FUNCTIONS: The Case Manager will enhance the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Case Manager will adhere to strict departmental goals/objectives, standards of performance, regulatory compliance, quality patient care compliance, and policies and procedures.

Primary Duties and Responsibilities

• Coordinate the integration of social services/case management functions into the patient care, discharge, and home planning processes with other departments, external service organizations, agencies and healthcare facilities.
• Conduct concurrent medical record review using specific indicators and criteria as approved by medical staff. Acts as patient advocate: investigates and reports adverse occurrences, and performs staff education related to resource utilization, discharge planning and psychosocial aspects of healthcare delivery.
• Promote effective and efficient utilization of clinical resources and mobilizes resources to assist in achieving desired clinical outcomes within specific timeframe.
• Conducts review for appropriate utilization of services from admission through discharge. Evaluate patient satisfaction and quality of care provided.
• Communicates with physicians at regular intervals throughout hospitalization and develops an effective working relationship. Assist physicians to maintain appropriate cost, case, and desired patient outcomes.

Other responsibilities may include:

• Coordinates the provision of social services to patients, families, and significant others to enable them to deal with the impact of illness on individual family functioning and to achieve maximum benefits from healthcare services.
• Complete expanded assessment of patients and family needs at time of admission. Complete psychosocial assessment.
• Refers cases where patients and/or family would benefit from counseling required to complete complex discharge plan to social worker.
• Facilitates interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified post-hospital needs.
• Directs and participates in the development and implementation of patient care policies and protocols in order to provide advice and guidance in handling special cases or patient needs.

KNOWLEDGE, SKILLS AND ABILITIES

• Proven working experience in case management.
• Excellent knowledge of case management principles, healthcare management and reimbursement.
• Previous experience with psychological aspects of care.
• Effective communication skills.
• Excellent organizational and time management skills.
• Familiarity with professional and technical emerging knowledge.
• Problem solving skills and ability to multi-task.
• Compassionate with teamwork skills.
• Fluent in English.

EDUCATION / SPECIALIZED KNOWLEDGE REQUIREMENTS

• Licensed professional nurse, RN, LPN, etc.
• Minimum of seven (7) plus years of utilization review/case management.
• Minimum of seven (7) plus years of experience in discharge planning from a hospital is preferred.
• Maintain current professional licensure in nursing or professional field of certification.
• Hospital, healthcare setting experience important.

We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.

ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.