The Case Manager is responsible to ensure case management clients receive appropriate services at all stages of care in all areas and adheres to CMSA standards of practice. Assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet clients’ psychological and physical needs. Performs duties in a patient centered manner and involves patients/families in plan of care. The CM provides evaluation of service efficiency and excellence, and client education. The CM actively participates and facilitates tracking of cost, resource management and quality improvement parameters. The CM coordinates assessment, screening, third party payor authorization, and discharge activities providing linkages to health and wellness resources across the health care continuum. The CM uses clinical expertise and problem solving skills to achieve optimal clinical and resource outcomes within effective time frames. The CM promotes interdisciplinary collaboration with a team approach and champions service excellence. The CM promotes open and timely communication and educates BHD clients and appropriate health care providers as to covered benefits and alternative options across the care continuum. The CM makes indicated client referrals and supports physicians in medical case management. The CM coordinates other medically related services efforts as required.

Minimum Education, Experience, Training, and Licensures Required:

Graduate from an accredited School of Nursing required, Bachelor of Science in Nursing preferred. Current licensure as a Registered Nurse by the Kentucky Board of Nursing or compact state license. Certification in area of expertise preferred. EXPERIENCE: Minimum of three years clinical experience required. Case Management experience preferred. Utilization and Quality Management experience preferred. Proven skills in assessing, planning, and managing patient care required. Basic knowledge of national utilization standards and case management standards of practice needed. Knowledge Base of various computed software and use of computers preferred. Basic knowledge of statistics required. Excellent communication skills demonstrated, verbal and written, mandatory. Excellent Customer Service and problem-solving skills.