Case Manager Job at Braden Health LLC
This position requires knowledge of medical review criteria utilized to evaluate the medical necessity for admission and continued stay in an acute care facility. Knowledge of community resources, discharge planning and referral to nursing home, extended care, rehabilitation or other facilities as appropriate is essential. Must have the technical skills necessary to demonstrate progressive care programs to patients and/or families. The ability to retrieve, communicate, and present data and information verbally and in writing as required. Strong interpersonal skills and the ability to communicate effectively with patients, families, nursing staff, physicians, and community resources is required.
Position Duties and Responsibilities:
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Observe professional ethics in maintaining confidential information acquired concerning the personal, financial, medical, or employment status of Houston County Community Hospital patients and their families
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Must follow accepted safety practices for the patient and the hospital
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Must report safety hazards and initiate appropriate action
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Must participate in safety instructional programs
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Must perform medical necessity reviews following Interqual criteria and document findings in MCCM
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Must obtain precertification for all admissions requiring prior authorization
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Must complete a discharge planning assessment on all inpatients and arrange any needed post-acute care services
Facility General
Responsibilities:
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Attend facility new hire orientation as scheduled by HR
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Complete Department Orientation Initial Competency within 7 days of hire date
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Complete Department Initial Skills Competency within 90 days of hire date
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Follow facility and OSHA safety rules and procedures
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Respect cultural and religious practices of patients from all backgrounds
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Follow HIPAA regulations at all times
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Be punctual and dependent for assigned shifts
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Dress within the dress code requirements of the facility
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Identifies all patients using at least two identifiers verbally (name and DOB), and by checking ID bracelet
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Follows Hospital Wide and Department Specific policies and procedures
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Must interact with physicians, guest, staff, and patients pleasantly, cooperatively, and effectively
Knowledge, Skills, and Abilities:
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Theoretical knowledge of clinical processes, case management, and continuity of care
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Motivation for self-direction
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Ability to demonstrate leadership skills
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Ability to relate to and work with chronically ill and disabled patients of all ages and with emotionally upset, and at times, hostile people within the facility
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Ability to relate to and work with various managed care representatives, defining the continuing need for medical treatment
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Ability to understand and integrate financial and medical needs of the patient
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Ability to work closely with physicians and provide guidance regarding criteria and HMO requirements
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Speak and read English fluently
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Must be emotionally mature and able to function effectively under stress
Position Requirements: Education,
Work Experience,
Licensure
, Certifications
;
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LPN or RN diploma or ASN required, BSN or MSW preferred. Exceptions will be made only based on extensive experience
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Minimum of 3 years of clinical experience
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Basic Life Support Certification
Working Conditions:
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Seated, with occasional walking and standing
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Work near others, usually within a few feet
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May work in a noisy or distracting environment
Statement of Non-Inclusivity:
This job description has been designed to indicate the general nature and level of work being performed by the employee within this classification. It is not designed to contain or be interpreted as a comprehensive list of all duties, skills, responsibilities, and qualifications which may be required of or given to any employee assigned to the position. The skills, duties, requirements, and responsibilities outlined in this job description may be changed or added to when deemed appropriate and necessary by the company or the person who is designated to be managerially responsible for this position. Receipt of the job description does not imply nor create a promise of employment, nor an employment contract of any kind. Employment with the company is an at-will relationship.
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