CASE MANAGER SUPPORT

General Summary/Responsibilities:

STATUS: PRN / Support

Department: INTEGRATED CARE MGT PROGRAM

Facility: Upper Valley Medical Center

Under the general supervision of the Manager of Integrated Care Management, the Care Manager works collaboratively with the Care Management Team to interact with patients/families and healthcare providers to insure that cost effective, quality care is provided throughout the continuum of healthcare. He/She assesses, implements, coordinates, monitors, evaluates and communicates options/services needed to meet the individual’s healthcare needs, thus promoting quality & cost effective outcomes. The Care Manager provides a timely review of the patient’s medical record for care management activities, including but not limited to: discharge/transition planning, clinical documentation, utilization management issues (recidivism/length of stay, care delays and avoidable days), admission/continued stay reviews, addressing status issues, providing severity/intensity of illness criteria for CMS and third party payers, and make referrals to Social Services, Home Care Liaison, and Patient Education). He/she participates in risk management and quality measures: recidivism, core measures, missing H&Ps, post-operative note, etc. The Care Manager is in direct contact with patient/family/providers, participates in daily “huddles” on unit for purpose of care coordination and identification of possible barriers to discharge, and actively supports patient and physician satisfaction goals. The Care Manager also mentors and acts as a resource to other health care providers in care management techniques and quality issues. Patients may range in age from newborn to an elderly patient population based on specific assignments.

• Professional knowledge of nursing theory and practice at a level normally acquired through completion of a nursing degree at an accredited School of Nursing. Additional nursing continuing education preferred. BSN required.
• Current Ohio State license as a Registered Nurse required.
• Three to five years of recent acute care experience in combination with/or with knowledge of utilization and case management principles.
• Interpersonal skills necessary in order to instruct and comfort patients and their families, and maintain effective contacts with a variety of hospital personnel. Recognizes and reinforces positive efforts of all co-workers.
• Analytical skills necessary for problem solving and conflict resolution.
• Ability to learn basic computer skills. Word and Access experience preferred.