Case Manager

Overview

The Case Manager is accountable for coordinating the care and service of selected patient population across acontinuum of care; ensuring and facilitating the achievement of optimal quality, clinical and cost outcomes;coordinating services and resources needed by the patient and family; and assuming a leadership role with themultidisciplinary team.

Special Instructions

Responsibilities

Coordinates and collaborate with physicians, provider, multidisciplinary team and other health care professionalsconcerning patient’s goals, plan of care and progress.Develop, implement, interpret and maintain work standards and procedures that are in compliance with ARH’spolicies and governmental regulations and various regulatory agency requirements.Maintain up-to-date knowledge in the field to allow recommendation of new services, products and equipment.Assesses, develop, implementation, and monitors comprehensive plan of care through an interagency multidisciplinary team process in conjunction with the patient and family internal and external settings.Revise and adjust on a daily basis the plan of care to accommodate the needs of the individual patient based oncontinuing assessment of patient condition.Assumes responsibility and accountability for the care plan and effectiveness and patient outcomes.Assesses the appropriateness of the level of care; diagnostic testing and clinical procedures; quality and clinicalrisk issues; and documentation of medical record completeness.Develop, implement, monitor and evaluate clinical pathways and clinical pathway variances.Monitor patients' progression through clinical pathways.Communicates continually with patients, families, medical staff, caregiver and third payors as necessary.Assist the patients and families with the educational process prior to admission, during hospital stay and afterdischarge, as indicated.Assures patients understand the third-party payer guidelines and to arrange discharge planning referrals asordered by patients’ physicians.Develops and maintains a positive work climate and supports the overall team effort of the hospital.Assists in collecting and analyzing outcome data.Performs other duties as assigned or directed.

Qualifications

Education (experience can be substituted for education)Associate's Degree Nursing Preferred

Work Experience (education can be substituted for experience)4-6 years Preferred

Knowledge, Skills and AbilitiesAdvanced knowledge of problem solving and decision making skills.Strong multi-tasking abilities with the ability to handle competing deadlines; flexible and adaptable.Ability to deal tactfully with customers and community.Advanced communication skills used to lead a team.Advanced execution and delivery (planning, delivering, and supporting) skills.Ability to consider the relative costs and benefits of potential actions to choose the most appropriate one.Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients.Mastery knowledge of phases of care transitions and resources available for patients.Mastery of digital literacy skills.Ability to handle sensitive information ethically and responsibly.

Licenses and CertificationsRegistered Nurse PreferredLPN Required