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Job Description Summary

The Case Manager is responsible for performing case management and discharge planning in the acute care setting. They provide a seamless link between the patient, healthcare team and physician through direct patient contact, comprehensive care planning, implementation of discharge plans and evaluation of plan toward patient goals. The Case Manager collaborates with all components of the healthcare system, managing appropriate use of community resources and post-acute providers to aid in the achievement of quality outcomes, fiscal responsibility and patient satisfaction.

Job Description

Essential Functions

• Performs assessments/evaluations of patients in acute settings for post hospital care needs.
• Develops plan for post-acute care that meets the needs of the patient as well as their goals of care with a working knowledge of medical necessity as it applies to post-acute care.
• Responsible for implementation of the plan within a timely manner so as not to delay discharge.
• Performs follow-up assessment during patients’ continued stay to evaluate for need to modify the discharge plan.
• Performs readmissions assessments on patients that readmit within thirty (30) days of previous discharge for any quality or safety concerns with previous discharge plan or care.
• Independently handles communications with patients, families and medical care team in a manner that decreases conflict.
• Promotes informed decision making and empowers patients to be active participants in formulating a plan of care.
• Assesses the physical, psychological, social, coping, environmental and financial status of patients to screen and identify those at risk for adverse outcomes
• Collaborates with medical staff and nursing staff regarding assessment changes that would influence discharge planning and promote continuity of care.
• Assesses medical necessity for acute care as it impacts the discharge plan.
• Performs other duties as requested by primary manager that do not compromise moral code of conduct or protocols set in place for patient or employee safety

Supervised Positions

• None

Qualifications

Minimum Education Required

• Associate in Nursing or Bachelors in Social Work (BSW);
• Current Licensure in the State of Alabama as a Registered Nurse or Social Worker
• Or licensure with the Alabama State board of social work within three (3) yrs of hire date.

Minimum Education Preferred

• Bachelors of Science in Nursing (BSN) or Master’s in Social Work (MSW);
• Current Licensure in the State of Alabama as a Registered Nurse or Social Worker

Minimum Experience Required

• Two (2) years acute care experience or
• Community resource or public health experience as it relates to transition of care from a hospital or
• Completion of three hundred (300) or more internship hours at this facility prior to graduation

Minimum Experience Preferred

• Previous hospital based case management experience
• Completion of any required supervisory hours as defined by the Alabama Board of Social Work

Required Knowledge/ Skills/ Abilities

• Maintain current licensure in the State of Alabama
• Demonstrates advanced computer skills
• Clinical knowledge and experience in the care of patients with multiple and complex diagnoses, disease process, and care needs.
• Demonstrates appropriate utilization of the skills as approved by the Alabama Board of Nursing or Social Work
• Ability to quickly adapt to changing circumstances in fast-paced environment
• Actively accepts, understands, and practices appropriate standards of nursing or social work practice.
• Utilizes advanced knowledge to assess the physical, psychological, social, coping, environmental and financial status of patients to screen and identify those at risk for adverse outcomes.
• Demonstrates basic knowledge of medical necessity for acute care as it impacts the discharge plan.
• Ability to prioritize work and meet deadlines.
• Ability to problem solve in a proactive, creative manner, using sound judgment based on factual information and clinical knowledge.
• Ability to develop leadership skills and to serve as a role model for clinical staff.
• Ability to lead and actively participate in multidisciplinary teams.
• Ability to work independently within a team structure.
• Demonstrates responsibility for educational requirements as evidenced by reading all assigned related references, and attending all required educational meetings, or webinars, and completing annual Symplr requirements.
• Ability to be reached by cell phone for on-call duties
• Demonstrates commitment to organizations five (5) priorities and Six Ground Rules
• Person in this position is required to understand, agree upon and follow our Six Ground Rules:
  • No excuses.
  • We are a team.
  • Bring up your ideas.
  • Poor performance will be addressed.
  • ‘That’s not my job’ is not acceptable
  • Manage Up.

Shift

Day

Shift Details

8:00 am - 4:30 pm

FTE

0.2

Type

Per Diem

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Equal Employment Employer

Southeast Health is committed to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Southeast Health will provide reasonable accommodations for qualified individuals with disabilities.