Position Summary
Manage a designated caseload to coordinate and complete timely assessment, planning, implementation and evaluation of discharge plans and care transitions across the continuum of care. Ensure optimum utilization of the patient's and the Health System's resources and perform these duties within the requirements of CMS and other external review agencies.
Responsibilities
Monitor daily census and assignment to assure all patients are assessed for case management needs including care coordination/transition and discharge planning, consultations, advocacy, education.
Maintain effective communication with health care team members related to assessment findings, discharge planning needs and provider orders needed to arrange Homecare, Durable Medical Equipment, Transportation, Skilled Nursing or Acute Rehab Facility placement, Substance Abuse Treatment and outpatient follow-up.
Maintain working knowledge of specific benefits and reimbursement guidelines, the discharge planning process and applicable federal, state and local regulations. Provide education and guidance on these topics to providers, patients and families as needed.
Work with Utilization Management partners to provide information and feedback that will enhance negotiations and denial prevention with payers.
Maintain timely documentation of assessment findings, discharge arrangements and actions taken according to departmental guidelines; prepare reports and maintain records as requested and/or required.
Monitor daily census and assignment to assure all patients are assessed for case management needs including care coordination/transition and discharge planning, consultations, advocacy, education.
Seeks direction when indicated for unusual or non-routine duties; advise appropriate personnel (i.e., Supervisor) of situations requiring nursing, administrative or technical expertise and follow-up; establishes and maintains positive, productive working relationships within the department/service line team as well as with other ECU Health departments; and, recognizes which decisions may be made independently and which require team and/or supervisory input and when this recognition is made, pursues the course of action in an efficient manner.
Orients new team members to the role when assigned.
Minimum Requirements
Master's degree in Social Work , Counseling (Clinical), and/or Marriage & Family Therapy, (may consider Master's in Psychology if full licensure as any of the above disciplines has been obtained).
North Carolina full licensure to practice as professional Social Worker (LCSW), Counselor (LCMHC), or Marriage& Family Therapist (LMFT).
Non-Violent Crises Intervention certification within 60 days of hire for all inpatient roles required.
3 years of relevant clinical case management experience required.
Pay Range
$68,806 - $100,294
