200 Case Manager Jobs in Washington, DC
United Medical Center is Hiring a Case Manager Near Washington, DC
Provides hospital case management, including utilization review, care coordination and clinical discharge planning to assure that the patient progresses through the continuum of care and is discharged to the least restrictive environment. Coordinates the integration of the social service function into patient care. Coordinates the hospital activities concerned with case management and discharge planning. Adheres to departmental goals, objectives, standards of performance, and policies and procedures. Ensures compliance with quality patient care and regulatory compliance.
Job Responsibilities:
- Coordinates the integration of social services/case management functions into the patient care, discharge, and home planning processes with other hospital departments, external service organizations, agencies, healthcare facilities and community resources.
- Facilitates Medical Necessity Determinations, regarding admissions or continued stays, extended stay, professional services.
- Ensures patient is in the appropriate “Status” and appropriate “Level of Care”; seeks out Secondary Physician Review when warranted. Assesses Emergency Room patients for Observation or Inpatient status as applicable, minimally every four (4) hours.
- Conducts concurrent medical record review using specific indicators and criteria as approved by medical staff, The Joint Commission, CMS, and other state agencies.
- Manages Payer Interface, real-Time Denial Management, including sending applicable clinical information to Payers (via NaviHealth).
- Ensure timely payer notification and communication to support admission, clinical condition, continued stay, authorization of post-acute services.
- Acts as a patient advocate: investigates and reports adverse occurrences, and performs staff education related to resource utilization, discharge planning and psychosocial aspects of healthcare delivery.
- Promotes effective and efficient utilization of clinical resources. Manages Length of Stay (LOS), including avoidable delays and days, and participates in long LOS rounds.
- Mobilizes resources and interviews, as needed, to achieve expected goal(s) to assist in achieving desired clinical outcomes within the desired timeframe.
- Manages sequencing, to ensure consults, tests and procedures ae sequenced appropriately and supports timely and efficient delivery of care.
- Conducts review for appropriate utilization of services from admission through discharge. Evaluates patient satisfaction and quality of care provided.
- Assesses patient care required throughout continuum of care for diagnosis, procedures and DRG’s.
- Communicates with physicians at regular intervals throughout hospitalization and develops an effective working relationship. Assist physicians to maintain appropriate cost, case, and optimal patient outcomes.
- Completes Initial Case Management Assessment and Reassessment on patients, including expanded assessment of patients and family needs at time of admission. Completes psychosocial assessment as applicable.
- Screens/identifies clinical, psychosocial, financial, operational factors affecting progression of care.
- Assess patient’s progress through expected hospital course.
- Assesses and identifies patients with post-acute needs, including Readmission Avoidance.
- Medical/Clinical Discharge Planning, hand-off post-acute placement to Social Worker.
- Refers cases where patients and/or family would benefit from counseling required to complete complex discharge plan to social work.
- Establishes Discharge Plan at admission and continually reevaluate, triggers referral to Social Worker (hand-off).
- Serve as a patient advocate. Enhances a collaborative relationship to maximize the patient’s and family’s ability to make informed decisions.
- Facilitates interdisciplinary/multidisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified post-hospital needs, as well as address discharge barriers early.
- Collaborate with clinical staff in the development and execution of the plan of care and discharge plan including the achievement of goals. Ensure Plan of Care and discharge plan clinically appropriate and consistent with patient choice and available resources.
- Directs and participates in the development and implementation of patient care policies and protocols in order to provide advice and guidance in handling special cases or patient needs.
- Minimum of two (2) years of utilization review/case management experience or social work experience. Minimum of one (1) year experience in discharge planning from a hospital is preferred.
- Graduate of Accredited school of Nursing with RN degree.Bachelor’s degree in healthcare related field preferred. Bachelors or Masters degree in related healthcare may be considered.
- Maintain current professional licensure in nursing or healthcare professional field.
- Appropriate certification in case management preferred (e.g. Commission for Case management Certification (CCMC) and Association of Rehabilitation Nurses (ARN)), but not required.
Job Summary
Full Time
$94k-113k (estimate)
01/25/2023
05/17/2024
united-medicalcenter.com
Linthicum Heights, MD
500 - 1,000
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The job skills required for Case Manager include Case Management, Patient Care, Coordination, Planning, Social Work, Discharge Planning, etc. Having related job skills and expertise will give you an advantage when applying to be a Case Manager. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Case Manager. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Case Manager positions, which can be used as a reference in future career path planning. As a Case Manager, it can be promoted into senior positions as a Case Management Director that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Case Manager. You can explore the career advancement for a Case Manager below and select your interested title to get hiring information.
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