Case Manager, Crmc

MU Healthcare is looking for a dynamic and compassionate Case Manager to join our team! If you are driven by the desire to make a positive impact on patient's lives and thrive in a collaborative environment, we want you! As a key collaborator with our service line professionals, including MDs, nurses, and therapists, your role will be pivotal in coordinating care and ensuring the appropriate utilization of resources and services. Join us in this fulfilling journey of compassionate care and professional growth!

Location: Jefferson City, Missouri

Shift: Variable shifts

Department: Care Coordination

Salary Range: $59,322 to $96,762 based on experience.

Essential functions:

• Assess and screen admission to promote early transition planning and risk of readmission; implement pathways and protocols to mitigate readmission.

• Assist in development of plan of care for the delivery of appropriate services for patients/caregivers in conjunction with patient, family, patient's physician, and other providers. Counsel, plan and implement discharge transitions with patients and families considering age specific needs.

• Arrange/authorize the delivery of appropriate services as agreed to by patient/caregiver. Coordinate the course of care delivery to ensure timely provision of services and achievement of outcomes.

• Facilitate and coordinate patient progression along continuum of care and discharge planning of complex need patients and or payers. Develop individualized plan of care protocols, pathways, and guidelines by service line, diagnosis, social determinants, or special needs. Interact with the multidisciplinary team to ensure accurate and high-quality documentation practices, policies, and regulations.

• Monitor the delivery of services for timeliness and appropriateness, adherence to plan, quality, and cost escalating issues to attending physicians and hospital leadership.

• Collaborate with other providers (physicians, home care agencies, etc.) to discuss patient/caregiver needs services. Participate in developing community relationships.

• Serve as liaison between other providers, the payer, and the physician, providing ongoing education regarding physician documentation requirements and utilization issues.

• Counsel patient and family, provide assessment of biopsychosocial issues and maintain compliance with mandatory reporting for patient safety issues.

• Work in tandem with legal entities within organization and outside of organization in best interests of the individual patient. Prepare interrogatories and testimony to legal entities as needed.

Required Qualifications:

• Three (3) years of clinical experience, which provides knowledge, and understanding of medical terminology, patient diagnoses, treatment protocols and disease process.

• One of the following:

• Master of Social Work degree, or Licensed Master Social Worker (LMSW) or Licensed Clinical Social Worker (LCSW) licensure by the Missouri State Committee for Social Workers board, or

• Missouri Board of Nursing RN or Nurse Licensure Compact multi-state RN. When primary state of residency changes, compact state RNs must apply under new state of residency within thirty (30) days, or

• Occupational Therapist (OT) licensure by the Missouri Board of Occupational Therapy, or

• Speech Language Pathologist (SLP) licensure by the Missouri Commission for Speech-Language Pathologists, and Certificate of Clinical Competency (CCC) certification from American Speech-Language-Hearing Association (ASHA), or

• Physical Therapist (PT) licensure by the Missouri Board of Registration for the Healing Arts or PT Compact multi-state privilege. When primary state of residency changes, compact state PTs must apply under new state of residency within thirty (30) days.

Preferred Qualifications:

• Case management certification or other related specialty.

• Experience in case management, social work or utilization management work.

• Additional license/certification requirements as determined by the hiring department.

Physical Demands: The physical demands described here are representative of those that must be met with or without reasonable accommodation. The performance of these physical demands is an essential function of the job. The employee may be required ambulate, remain in a stationary position, and position self to reach and/or move objects above the shoulders and below the knees. The employee may be required to move objects up to 10 lbs