Case Manager

Education Required: Graduate of an accredited school of nursing Preferred: Bachelor's of Nursing Experience Required: Minimum of 1 year hospital experience Skills Excellent interpersonal skills, including ability to be genuine and empathetic Excellent communication (verbal and written) skills with attention to detail Computer skills Ability to interact professionally and contribute to the interdisciplinary team Licensure/Certification/Registration Current RN License in the state of Missouri Preferred: Certified Case Manager Overall Physical Demands Material Handling Occasional Unilateral Lifting 5 Pounds Unilateral Carry 5 Pounds Repetitive Functional Activities Never Occasional Frequent Constant Walking X Above Shoulder Reach X Bending X Stairs X Forward Reach X Ladder X Squatting X Fine Motor Coordination X Static Balance X Sustained Squatting X Dynamic Balance X Gross Motor Coordination X Repetitive Kneeling X Sustained Kneeling X Simple Grasp X Crawling X Firm Grasp X Pinching X Sit/Stand Hrs per Day Hrs at One Time Sit 6 hours 2 hours Stand 2 hours 15 minutes Resource/Transitional Care Specialist Material Handling Occasional Unilateral Lifting 5 Pounds Unilateral Carry 5 Pounds Repetitive Functional Activities Never Occasional Frequent Constant Walking X Above Shoulder Reach X Bending X Stairs X Forward Reach X Ladder X Squatting X Fine Motor Coordination &nbs Position Competencies: Competencies are essential skills needed to be successful in a position. These competencies are required to help the department maintain a high level of productivity and success. Each competency will be evaluated by observation. If evaluated by another method i.e. simulation, discussion or post test please note in the comment box below each corresponding competency. Department Performance: Responsible for the quality of services to enhance the experience of all customers, both internal and external. Strives to meet departmental goals and expectations through the implementation of best practices; identifies challenges to meet goals; and provides solutions through innovation as evidence by department scorecard. Participates in department/hospital performance initiatives to attain specific goals set forth by management. Logs/documents per hospital policy and department standards. Assessment Conducts comprehensive patient/family assessment and discharge planning evaluation upon admission and at regular intervals as requested to initiate and maintain the patient's discharge plan of care. Reviews patient's medical record to determine health status and risk factors to evaluate the likelihood of the patient's capacity for self-care or the possibility of the patient being cared for in the same environment from which he/she entered the hospital Identifies patient/family education needs and ensures that patient/family members have adequate information to participate in discharge planning and that they are given choices to the degree possible when the patient requires post-acute hospital services. Access to Care Keep current on regulatory changes that affect delivery or reimbursement of acute care services. Understands and applies the federal law regarding the use if Hospital Initiated Notice of Non-Coverage. Consult with Physician Advisor and Case Management Director as needed regarding progression of care barriers resolution. Collaborate with clinical team reviewing actual and proposed medical care and services against CMS coverage guidelines. Continuing Stay Collaborate with the interdisciplinary team, patient, and family to facilitate appropriate progression along continuum of care. Serve as a proactive member of the interdisciplinary team and serve as a primary liaison for physicians, patient, family, and external case managers to gather sufficient information to determine the effectiveness of treatment plan, patient care goals, and appropriateness of treatment/discharge plan. Identify and document preventable delays of progression of care processes. Identify potentially unnecessary services and care delivery setting and recommend alternatives if appropriate. Promote the use of evidence based care. Transition Collaborate with multidisciplinary team in facilitating referrals for appropriate post-acute care and update all parties involved of progression/authorization. Serve as a resource person to physicians for coverage and compliance issues. Assure discharge plan is addressed during multidisciplinary rounds. Aware of payer benefits, financial considerations, family dynamics, and the impact on the discharge plan, collaborating with the multidisciplinary team for needed modifications. Identify patients at risk for readmission and refer for community based follow up. Collaborate with Social Worker for discharge placement when home discharge is not possible.