Position: Case Manager
Department: Nursing Administration
Reports to: Administrator
FLSA Status: Salaried/Exempt
Summary:
Provide person-centered support and guidance to residents and their families as they transition through the health care continuum. Collaborate with residents, family, and providers of health care to achieve continuity and optimum care at a cost effective level. Also responsible for assessing, planning, implementing, and evaluating individual resident care needs along with MDS. Analyze care as it is delivered and initiate adjustments based upon needs and thorough utilization review.
Environment:
Work will be performed primarily indoors at one of our long-term healthcare facilities, throughout all areas, including in resident rooms, and on carpeted and/or tiled floors. Work will be performed there routinely around other co-workers, healthcare staff, residents, and guests. Due to the nature of facility’s business, worker may be exposed to occasional slippery floors, object on floors, chemicals, sharp objects, hazardous materials and waste (including human), blood borne pathogens, and communicable diseases, as well as high-stress medical and/or life threatening situations.
Essential Duties & Responsibilities:
- Meet physical and sensory requirements stated below, and be able to work in the described environment.
- Identify and participate in process improvement initiatives that improve the customer experience, enhance work flow, and/or improve the work environment.
- Collaborate regularly and maintain open communication with residents, families, internal care givers, and external case managers.
- Coordinate internal and external health care team activities related to resident care, transitions and discharge planning with agencies, and other healthcare organizations.
- Conduct initial baseline assessment of resident care needs and services.
- Document to support the need and authorization for services and outliers.
- Validate payor source on a regular basis throughout the month with the facility Business Office Manager.
- Participate in triple check and daily PDPM meetings and care plan meetings.
- Promote effective and efficient use of resources.
- Serve as a resident and family advocate.
- Provide staff education related to coordinating and managing resident care.
- Ensure that resident tests and procedures are appropriate, necessary, carried out within an established timeframe and reported promptly.
- Initiate and obtain authorization for identified referrals.
- Solicit resident and family feedback regarding satisfaction with care and respond quickly to unmet needs.
- Mobilize necessary resources to reach expected goals and outcomes within a desired timeframe.
- Other special projects and duties, as assigned.
Job Requirements:
- Registered Nurse in good standing with required current state license.
- Associates degree required, MDS experience and knowledge of the RAI process
- Minimum of three (3) years related nursing experience.
- Certified in Case Management through AANC, CCMC or other credentialed agencies, preferred.
- Must have a current/active CPR certification.
- Effective verbal and written English communication skills.
- Demonstrated intermediate to advanced skills in Microsoft Word, Excel, Power Point and Outlook, Internet and Intranet navigation.
- Highest level of professionalism with the ability to maintain confidentiality.
- Ability to communicate at all levels of organization and work well within a team environment in support of company objectives.
- Customer service oriented with the ability to work well under pressure.
- Strong attention to detail and accuracy, excellent organizational skills with ability to prioritize, coordinate and simultaneously maintain multiple projects with high level of quality and productivity.
- Strong analytical and problem solving skills.
- Ability to work with minimal supervision, take initiative and make independent decisions.
- Ability to deal with new tasks without the benefit of written procedures.
- Approachable, flexible and adaptable to change.
- Function independently, and have flexibility, personal integrity, and the ability to work effectively with stakeholders and vendors.
Physical and Sensory Requirements:
- Moderate physical activity:
o Push, pull, move, and/or lift a minimum of fifty (50) pounds to a minimum height of three (3) feet and be able to push, pull, move, and/or carry such weight a minimum distance of fifty (50) feet.
o Standing and/or walking for more than four (4) hours per day.
o Bending and/or stooping for more than one (1) hour at a time.
o Sitting for more than two (2) hours at a time.
o Requires writing and/or computer work with repetitive typing and concentrating on computer screen and/or documents for more than two (2) hours at a time.