Responsible for coordinating the exchange of pertinent clinical and medical information between the admitting psychiatric facility or prison facility and the current GHI treatment program as well as other relevant involved parties.
Perform duties related to the day-to-day operations of the High Risk Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life.
Oversee the assessment, planning, facilitation, coordination, evaluation and advocacy for options and services to meet a patient and familys comprehensive health needs and to promote quality cost effective outcomes.
The RN Case Manager utilizes a collaborative process of assessment, planning, implementation and evaluation, to engage, educate, and promote/influence members decisions related to achieving and maintaining optimal health status for our Americas International membership.
Manages the daily operations of RN case management staff to meet department objectives of determining medical necessity of admissions, coordination of appropriate plans of care, discharge planning, documentation, referrals, and care facilitation.
Working with the healthcare team, the case manager monitors the LOS, the appropriate utilization of care, promotes quality, provides clinical review for the payers, and plans / implements the discharge.
The RN Case Manager promotes the optimal health and well being of patients, their families and caregivers within their homes and communities using a holistic approach that empowers patients/families/caregivers to achieve their highest levels of physical, functional, spiritual, and psychological health.