Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems; perform duties independently, demonstrating advanced understanding of complex care management principles.
Perform duties related to the day-to-day operations of the Service Management functions for STAR Kids members to achieve the highest possible levels of functioning and wellness by ensuring consistent, timely access to medically necessary behavioral health services. Monitor quality of care, assist with discharge planning.
The Case Manager identifies, evaluates, and provides management of services for patients with complex, catastrophic, long term illness or injury, targeted diseases, as well as those patients receiving out of network services.
In this role, you will perform ongoing essential Case Management activities of assessment, problem identification, planning, implementation, coordination, monitoring, and evaluation of case managed members
Performs a nursing assessment on all patients. The data collected forms the basis of an individualized plan of care. Identifies teaching needs and goals related to the diagnosis of each patient from the nursing admission assessment and by collaborating with patient/family and the Interdisciplinary team.
The Case Manager job will coordinates management of care for a specified patient population in a single hospital; follow patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies.
Provides ongoing evaluation of the patient and family / caregiver response to care, and recommends alteration of the plan when necessary. Ensure continual assessment of patient and family needs from admission to Bridges home based care throughout the course of care.