Support the Case Management Director and Utilization Review Program
Monitors patient results, optimizing resource distribution and implementing continuing care plans to meet patients' post-discharge needs
Utilizes chart review, electronic medical record, patient/family interviews, along with the medical group data
Organizes plans and prioritizes caseload to optimize care coordination; prioritizes case management for individuals with higher risk factors
Evaluates discharge planning needs on admission inspection
Collaborates with patient/family, physicians, nurses, ancillary personnel and external agencies to develop safe, individualized, and appropriate continuing care plans
Support Director in management a staff of 10-25 case managers and Utilization Review team members
Support Director in Hiring, supervise and evaluate case management staff. Supervise a case management staff with diverse areas of expertise including job development;
Work collaboratively with Intake and Outreach staff, Director of Programs to meet program goals and performance targets.
Analyze program data and plan for program improvements;
With support from Director of Programs, submit monthly reports with quantitative and qualitative information with support from Case management Director.
Review/Audit of client files to ensure case management plans address identified needs, are up-to-date and that data quality is maintained;
Ensure case management staff are regularly monitoring client activity related to achieving personal and programmatic goals, and providing corrective action revisions to case plans as needed
Coordinate staff and scheduling and case management assignments;
Attend program-related community, coalition and committee meetings
Conduct or arrange for appropriate orientations, in-services, and training for program staff
Mediate client grievances and facilitate case management/client issues
Ensure that Case Managers continually monitor and evaluate each client's progression through their case management plan, developing corrective action revisions to the plan as needed.
Assist clients in obtaining necessary resources to achieve case management goals;
Actively participate in client- and program-related meetings and trainings
Attend program-related community, coalition and committee meetings as assigned;
Maintain client related data systems, including case notes
Prepare case management related reports including but not limited to: outcomes, successes, etc;
Adheres to strict boundaries and professional ethics in the care of others; Conducts crisis intervention as needed
Other requirements or duties as assigned
Creating and evaluating reports
Use of data analytics software
Degree in nursing, or related field required
Master's Degree preferred
Minimum of 5-7 years of clinical experience in a hospital setting, including (2) years of managing a high volume hospital facility 100 minimum bed or related function preferred.
Managed a staff of 10-25 staff
R.N, or applicable AL license preferred
Jackson Hosptial & Clinic