- Perform assessments/evaluations of patients in acute settings for post hospital care needs.
- Develops plan for post-acute care that meets the needs of the patient as well as their goals of care with a working knowledge of medical necessity as it applies to post-acute care.
- Responsible for implementation of the plan within a timely manner so as not to delay discharge.
- Perform follow-up assessment during patients' continued stay to evaluate for need to modify the discharge plan.
- Perform readmissions assessments on patients that readmit within thirty (30) days of previous discharge for any quality or safety concerns with previous discharge plan or care.
- Independently handle communications with patients, families and medical care team in a manner that decreases conflict.
- Promote informed decision making and empowers patients to be active participants in formulating a plan of care.
- Utilize advanced knowledge to assess the physical, psychological, social, coping, environmental and financial status of patients to screen and identify those at risk for adverse outcomes.
- Collaborate with medical staff and nursing staff regarding assessment changes that would influence discharge planning and promote continuity of care.
- Demonstrates basic knowledge of medical necessity for acute care as it impacts the discharge plan.
- None
- Associate in Nursing or Bachelors in Social Work (BSW);
- Current RN license in the state or license with the State Board of Social Work;
- Or licensure with the state board of social work within six (6) months of hire.
- Bachelors of Science in Nursing (BSN) or Master's in Social Work (MSW);
- Current RN license in the state or license with the state board of social work
- Two (2) years acute care experience or
- Community resource or public health experience as it relates to transition of care from a hospital or
- Completion of three hundred (300) or more internship hours at this facility prior to graduation
- Previous hospital based case management experience
- Demonstrates advanced computer skills
- Clinical knowledge and experience in the care of patients with multiple and complex diagnoses, disease process, and care needs.
- Ability to prioritize work and meet deadlines.
- Ability to problem solve in a proactive, creative manner, using sound judgment based on factual information and clinical knowledge.
- Ability to develop leadership skills and to serve as a role model for clinical staff.
- Ability to lead and actively participate in multidisciplinary teams.
- Ability to work independently within a team structure.
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Case Manager - Dothan, United States - Southeasth Health
Description
Description
Essential Functions
Direct Reports (supervised positions)
Qualifications
Minimum Education Required
Minimum Education Preferred
Minimum Experience Required
Minimum Experience Preferred
Required Skills/Abilities
Shift
Shift Details
8:00 am - 4:30 pm
FTE
Type