In this role, the selected candidate must be organized and a self-starter, be able to utilize multiple resources to determine health plan requirements and benefits as applied to the utilization and case management process and clinical decision making.
In this role, the selected candidate will be responsible for continuous review of all aspects of every patient on his/her caseload to include: appropriate utilization of services; ensuring continued skilled need; monitoring of homebound status; review of documentation in the medical record; maintenance of interdisciplinary communication and discharge planning.
In this role, the selected candidate will develop and implement local strategies using inpatient, outpatient, onsite and telephonic CM; develop and implement policies and protocols for home health assessments and outcome measures.
In this role, the candidate will complete initial case evaluation by assessing injury/disability severity, treatment plans, functional abilities and physical job requirements and then establishes case-specific target return-to-work (RTW) dates.
In this role, you will performs the primary functions of assessment, planning, facilitation and advocacy, which are achieved through collaboration with the client and other health care professionals involved in the clients care.