The case manager coordinates care across an episode and/or the continuum for clients with complex problems and diverse needs. The case manager’s focus is to maintain patients at an optimal level of health and to support self-care. Case managers collaborate with physicians, social services, nurses and community agencies to define care options and resources, to plan cost effective quality care and to achieve optimal outcomes.

Specific responsibilities include case screening, insurance approval, assurance of timely services, and facilitation of discharge with transition to the appropriate services. Patient outcomes are achieved through effective application of care plans, managed care concepts, appropriateness criteria, resource management, knowledge of community resources, and collaboration with other clinical disciplines. She/he works proactively to coordinate the services of physicians, nurses, and other disciplines to effectively prepare patients for discharge.

The case manager facilitates program development, efficient care delivery processes and quality improvement including: tracking of resource utilization and outcome measures. The case manager is accountable for improving service through the use of cost and quality outcome data, current clinical practices and related research, regulatory requirements and comparative benchmark opportunities.

Customers include: patients, families/visitors, physicians, physician assistants, nurse practitioners, case managers, representatives of third party payers, representative of referring agencies, interdepartmental and intradepartmental staff, vendors, and volunteers.

Minimum Qualifications:

• BSN

• Current RN license to practice nursing in the state where case management services are administered.

• Certification in the area of case management is preferred.

• Three to five years clinical experience required.

• Clinical competency in the case management of targeted population is desirable.

• Broad-based health care operational experience preferred.

Child and Dependent Adult Abuse Mandatory Reporter Training is required within 6 months of hire and every 5 years thereafter