The Case Manager works as a team member with several social service professional and paraprofessional staff ensuring the delivery of quality care in accordance to the rules and regulations established.
It involves telephonic outreach to perform comprehensive assessments of the patients condition, determination of available benefits and resources, and development and implementation of a care management plan with performance goals, monitoring and follow up.
The Registered Nurse/Case Manager utilizes the nursing process to coordinate the provision of safe and effective patient care post hospitalization that supports the achievement of therapeutic outcomes.
Participates in data collection and analysis of clinical outcomes of care and customer satisfaction standards. Participates in the formulation and implementation / monitoring of action strategies and outcomes of care or customer service.
The CCC participates in the development of the plan of inpatient care ,according to patient specific age and/or developmental needs. In collaboration with the multidisciplinary health care team, utilizes clinical pathways in support of the provision of care.
The Senior Case Manager/Care Specialist CA Only is responsible for the coordination of services and cost effective management of health care resources to meet individual members health care needs and promote positive health outcomes.
The Clinical Care Coordinator (CCC), or Case Manager under general supervision, the CCC acts independently in coordinating and tracking patient care, and providing discharge planning for patients within an episode of illness.
The successful candidate has proven leadership skills and knowledge of state regulatory requirements and URAC. The RN Case Manager will work Monday through Friday during normal business hours in a comfortable and modern professional office environment.