Nursing Case Manager

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Position Highlights

Position Accountable To: Director of Nursing

Job Summary:

Collaborates with the multidisciplinary care team to bring together an established plan for patient admission process, coordination, plan of care, and assists with the transitions between levels of care to promote the best possible patient outcome. The case manager facilitates efficient utilization of resources and identifies patient care needs throughout the continuum of care. Demonstrates knowledge of the principles of growth and development and possesses the ability to respond to specific issues and data reflective of the patient/customer’s status. Demonstrates knowledge and skills necessary to provide care for the population served in the department.

Essential Job Functions:

• Coordinates admissions and discharge planning.
• Acts as liaison with hospitals and other health care services to provide plan of care advice and lobby on behalf of the patients to various payor sources.
• Identifies community resources which can help with non-covered benefits such as medications, nutritional supplements, transportation, or durable medical equipment.
• Completes documentation, obtains insurance prior authorizations, and coordinates scheduling of procedures, testing and treatments.
• Performs and assists with medical treatment teaching and follow-up care with patients and their families regarding their healthcare needs.
• Assists with the review and development of education materials offered to patients.
• Facilitates care conferences and discharge planning meetings to review/meet needs of patients.
• Demonstrates expertise in communication skills, promotes effective working relationships, and maintains confidentiality at all times.

Marginal Job Functions:

• Acts on committees as needed.
• Performs duties of RN or LPN as needed.
• Tracks and compiles data as requested.
• Assists in updating Nursing Policies and Procedures as directed.
• Assists with educational training, health fairs, etc. outside of the work facility.