The Case Manager is responsible for coordination of care and service delivery for an assigned group of patients and promoting inter-dependent communication and collaboration with the patient, caregiver, physician and other members of the health care management team. The Case Manager will assess, implement, coordinate, monitor and evaluate available services and resources to promote quality, cost effective outcomes appropriate to patient's needs and resources. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.
Effective November 29,2015, new hires (newly hired or rehired at MLH) or current Associates entering this job must also meet one of the following requirements:
Have a bachelor's degree or higher in nursing from an accredited program;
Be currently enrolled in an accredited nursing program to complete a BSN or MSN within 3 years of hire date (written agreement required); or
Sign a written agreement to enroll in an accredited nursing program to complete a BSN or MSN within 3 years of hire date.
At least two(2) years of clinical experience (acute or hospital inpatient).
Licensed to practice as a professional nurse in the state where work is performed or compact license.
CCM or ACM certification
Demonstrated oral and written communication skills required.
Demonstrated ability to develop and maintain working relationships with physicians and work collaboratively with health professionals at all levels to achieve established goals.
Demonstrated excellent facilitation skills.
Ability to plan and schedule tasks and to maintain control of own work flow.
General computer skills required, advanced computer skills preferred.
Ability to use initiative in decision-making; independent judgment and critical thinking skills.
Key Job Responsibilities
Performs and participates as part of the Case Management team to support a collaborative effort to facilitate quality patient care. This role integrates and coordinates various aspects of service delivery, care facilitation, payor authorizations, service access, discharge and post-discharge activities, and utilization review.
Identifies patients that meet criteria for case management services using an appropriate screening and assessment process.
Communicates necessary information to stakeholders and educates patients and families.
Plans effectively to meet patient needs, manage authorizations and length of stay, and promote efficient utilization of resources (fiscal, human, environmental, equipment and services).
Maintains reliable systems to document, track, and monitor assigned cases.
Performs other job functions as assigned or requested.
The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
Must have good balance and coordination.
The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
Frequent non-invasive patient contact
The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work.
This role may be scheduled for weekend and holiday rotations as required by the department.
Methodist Le Bonheur Healthcare