Care Manager II, Case Management - Full Time

Description

Summary :

The Care Manager (CM) II works in collaboration with thepatient / family, physicians and multidisciplinary team members toensure patient progression through the continuum of care and todevelop a plan of care for each assigned patient from admissionthrough discharge.

The CM is responsible for identifying,initiating and managing optimal patient flow / throughput to enhancecontinuity of care, smooth and safe transitions, patientsatisfaction, patient safety, and length of stay management.

Support and expertise are provided through comprehensiveassessment, planning, implementation, and overall evaluation ofindividual patient needs.

Care Coordination and Discharge Planningare both responsibilities of this role. The CM assesses andresponds to patient / family needs by coordinating efforts of otherteam members and identifies and resolves barriers that hindereffective patient care.

The CM adheres to departmental andorganizational goals, objectives, standards of performance,policies and procedures, and continually assures regulatorycompliance.

Responsibilities :

• Meets expectations of the applicable OneCHRISTUSCompetencies : Leader of Self, Leader of Others, or Leader ofLeaders.
• Coordinates the integration of casemanagement functions into the patient care and discharge planningprocesses in collaboration with other hospital departments,external service organizations, agencies, and healthcarefacilities.
• Coordinates / facilitates patient careprogression throughout the continuum of care in an efficient andcost-effective manner.
• Serves as resource, providessupport, and advocates on behalf of the patient related totreatment decisions and end of life issues.
• Closelymonitor patient length of stay in regard to the geometric meanlength of stay and communicate / collaborate with appropriateinterdisciplinary team members to remove barriers and expeditedischarge.
• Implements and monitors the patient’s planof care to ensure effectiveness and appropriateness ofservices.
• Identifies and escalates local and systembarriers that are impeding diagnostic or treatment progress andissues related to quality and risk as appropriate in a timelymanner.
• Proactively identifies and resolves delaysand obstacles to discharge.
• Uses advanced conflictresolution skills as necessary to ensure timely resolution ofissues.
• Collaborates with medical staff, nursingstaff, and ancillary staff to eliminate barriers to efficientdelivery of care in the appropriate setting.
• Interviews patients / families to obtain information about social,emotional, and financial factors which impact health status todevelop comprehensive discharge planning assessment and careplan.
• Assesses needs for discharge planning andcontinuing care / resource support following discharge; independentlymakes recommendations to patients and families regarding post-acutelevel of care needs and options including :
• AcuteRehabilitation Placement
• Nursing Home or SkilledNursing placement
• Psychiatric or Substance Abuseplacement
• New Dialysis
• Child / Adult / Domestic Abuse
• Home Health / HospiceReferrals
• Legal issues (adoptions,guardianship)
• Assistance with Advance Directives
• Community Resource needs
• FinancialIssues / Funding options
• DME Referrals andCoordination
• Social Determinants of Health
• Initiates discharge planning at the time of admission andmakes post-hospital service referrals based upon informationgathered during assessment and interactions with physicians,multidisciplinary care team, and payors as indicated.
• Acts as patient advocate by negotiating for, and coordinating,resources with payors, agencies, and vendors.
• Ensuresthat all elements critical to the plan of care have beencommunicated to the patient / family and members of the healthcareteam and are documented as necessary to assure continuity ofcare.
• Provide appropriate interventions whichdemonstrate knowledge of and sensitivity toward cultural diversityand the religious, developmental, health literacy, and educationalbackgrounds of the patient population.
• Assesses thepatient’s formal and informal support system as well as availablebenefits and / or community resources.
• Meets directlywith patient / family to assess needs and develop and individualizedcare plan in collaboration with the physician.
• Ensures and maintains plan consensus from patient / family, physicianand payor.
• Provides education, information,direction, and support related to patient’s goals of care.
• Acts as patient advocate to develop treatment plan andcoordinate patient care and to transition patient to theappropriate next level of care.
• Demonstrates andpromotes respect for the dignity and rights of every patient whileadhering to the safety standards and practices of the organizationand the nursing profession.
• Collaborates with thephysician and other health care professionals to promoteappropriate use of medical center resources.
• Providesinformation and support to patients and families, helping themaccess needed resources within the medical center andcommunity.
• Actively participates in clinicalperformance improvement activities involving length of stay,resource utilization, avoidable days, cost per case, andreadmissions.
• Measures effectiveness of interventionsthrough direct communication with post-acute care providers,patients, and caregivers.
• Promotes individualprofessional growth and development by meeting requirements formandatory / continuing education and skills competency.
• Actively participates in Multidisciplinary / Patient Care ProgressionRounds.
• Escalates cases as appropriate and per policyto Physician Advisors and / or CM Director.
• Documentsin the medical record per regulatory and departmentguidelines.
• May be asked to assist with specialprojects.
• May serve a preceptor or orienter to newassociates.
• Assumes responsibility for professionalgrowth and development.
• Must have excellent verbaland written communication and ability to interact with diversepopulations.
• Must have critical and analyticalthinking skills.
• Must have demonstrated clinicalcompetency.
• Must have the ability to Multitask and tofunction in a stressful and fast paced environment.
• Must have working knowledge of discharge planning, utilizationmanagement, case management, performance improvement, and managedcare reimbursement.
• Must have understanding ofpre-acute and post-acute levels of care and communityresources.
• Must have ability to work independentlyand exercise sound judgment in interactions with physicians,payors, patients and their families.
• Must beunderstanding of internal and external resources and knowledge ofavailable community resources.
• Must have the abilityto move around the hospital to all areas for the majority of theworkday while in office the rest of the day;

general office andhospital environment.

Requirements : Education / Skills

Education / Skills

Graduate of an accredited school of nursing (BSNpreferred) or Masters Degree in Social Work (MSW) required ordemonstrated success in CHRISTUS Care Manager I Position for atleast 5 years on top of the required experience in lieu ofeducation required.

Experience

Two or more years clinical experience with one year in the acutecare setting preferred.

Licenses,Registrations, or Certifications

• RN or LMSW in the state of employment is required fornew hires.
• LBSW accepted for associateswith 5+ years of demonstrated success and experience in CHRISTUSCare Manager I role.
• Certificationin Case Management preferred.
• BLSpreferred.

WorkSchedule : WorkType :

WorkType : FullTime

FullTime

EEO is the law - click below for moreinformation :

https : / / www.eeoc.gov / sites / default / files / 2023-06 / 22-088 EEOC KnowYourRights6.12ScreenRdr.pdf

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