- Assesses, plans, monitors, and coordinates plan of care from pre-admission to community re-entry through the implementation of case management standards and processes.
- Assesses the individual's personal and medical history, current status, diagnosis, prognosis, and the proposed treatment plan.
- Promotes and utilizes the appropriate level of care for the patient and refers to other facilities as needed.
- Adheres to contract agreements and specific criteria.
- Serves as a liaison with payor source points of contact to verify and guarantee coverage and identify items required to process the claim for service.
- Assists patient and or caregiver in developing realistic goals to direct the treatment regimen.
- Proactively communicates with payor source to explore coverage solutions (flex benefits, out of contract, etc.).
- Promotes optimal outcomes for the patient within the boundaries of the diagnosis.
- Coordinates and facilitates interdisciplinary team (IDT) meetings and plan of treatment.
- Meets with patient, family, and IDT to facilitate "continuity of care".
- Implements utilization review process and continuously evaluates the appropriate level of care with the interdisciplinary team and payor, and patient/caregiver(s). Proactively obtains authorization for any extension of service of LOS.
- Coordinates the discharge plan with the IDT and providers.
- Monitors expense versus revenue for caseload on a daily basis.
- Proactively collaborates with the health care team, payors, community agencies, providers and legal representatives to ensure continuity throughout the continuum.
- Serves as a liaison with the treatment team and the primary care physician, referring physician, medical director, patient/caregiver(s), and other parties as appropriate.
- Promotes effective communications among treatment team members, patient/caregiver(s), primary care physician, referring physician, medical director, and payor.
- Participates in care conferences, family conferences, etc. when indicated.
- Educates and supports the individual/family to be empowered and self-reliant in being advocates for themselves.
- Uses the mechanism of early referral to promote and provide optimum care and cost containment.
- Represents the individual's best interests through assisting in finding necessary funding, offering treatment alternatives, and coordinating treatment.
- Continuously reviews and evaluates the patient's progress, as reflected by the goals defined in the treatment plan.
- Uses appropriate auditing processes and tools to ensure department and treatment efficiency.
- Participates in performance improvement evaluation processes with particular emphasis on results-oriented treatment.
- Maintains professional growth in case management by: attending continuing education opportunities; reviewing pertinent professional literature; maintaining knowledge of current community resources; and reviewing and being familiar with the managed care marketplace to determine managed care growth potential, opportunities, penetration, service trends, relationships, networks, etc.
-
Case Manager
3 weeks ago
SHELTER, Inc Pittsburg, United States**ORGANIZATION**:SHELTER, Inc. is an independent, community-based non-profit organization created in 1986 to lead the effort to eliminate homelessness. We currently operate in Contra Costa, Solano and Sacramento counties. · **MISSION**:To prevent and end homelessness among low-in ...
-
Case Manager
1 week ago
PAM Health Oakdale, United StatesCase Manager(RN) · The Case Manager is responsible for the interdisciplinary coordination of care for a designated patient population. The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admi ...
-
Case Manager
3 weeks ago
Apex Ventures Wellsburg, United StatesOur city administration is only as strong as the sum of its employees (m/f/d). Become part of our team and actively shape Ulm. · We are looking for a · Case Manager (m/f/d) for the Department of Personnel and Organizational Development in the Department of Central Control and Se ...
-
rn case manager
3 weeks ago
PAM Health Oakdale, PA , USA, United StatesCase Manager · (RN) · The Case Manager is responsible for the interdisciplinary coordination of care for a designated patient population. The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of a ...
-
Case Manager
3 weeks ago
Holy Family Institute Pittsburgh, United StatesJob Details · Job Location · Main Campus - Pittsburgh, PA · Description · Journey of Hope Program · Case Manager - Bilingual Spanish (Preferred) · Reports to: Lead Case Manager · Hours: Full-time, exempt position with flexibility. · Responsibilities: The Case Manager is re ...
-
Case Manager
3 weeks ago
Holy Family Institute Pittsburgh, United StatesJourney of Hope Program Case Manager - Bilingual Spanish Reports to: Lead Case Manager Hours: Full-time, exempt position with flexibility. Responsibilities: The Case Manager is responsible for coordinating case management services. The Case Manager's tasks shall include developme ...
-
Case Manager
2 weeks ago
Holy Family Institute Pittsburgh, United StatesJob DetailsJob LocationMain Campus - Pittsburgh, PADescriptionJourney of Hope ProgramCase Manager - Bilingual Spanish (Preferred)Reports to: Lead Case ManagerHours: Full-time, exempt position with flexibility.Responsibilities: The Case Manager is responsible for coordinating case ...
-
Case Manager
1 week ago
Renewal Pittsburgh, United StatesCase Manager Reporting Relationship Case Management Supervisor Work Schedule As per schedule (shifts and weekends); on call Exemption Status Non-exempt Grade I - IV Definition. Provide guidance, direction, and management of the reentrants and their a Case Manager, Manager, Manage ...
-
Case Manager
4 days ago
Renewal Pittsburgh, United StatesJob Title Case Manager · Reporting Relationship Case Management Supervisor · Work Schedule As per schedule (shifts and weekends); on call · Exemption Status Non-exempt · Grade I - IV · Definition · Provide guidance, direction, and management of the reentrants and their acti ...
-
Case Manager
3 weeks ago
Light of Life Rescue Mission Pittsburgh, United StatesSince 1952, Light of Life Rescue Mission has been a safe refuge for homeless and hurting people in the Pittsburgh area. We currently seek a full-time Case Manager for the Women & Children's Longterm Program. This person will walk closely alongside clients in guiding them through ...
-
Case Manager
3 weeks ago
Light of Life Rescue Mission Pittsburgh, United StatesSince 1952, Light of Life Rescue Mission has been a safe refuge for homeless and hurting people in the Pittsburgh area. · We currently seek a full-time Case Manager for the Women & Children's Longterm Program. This person will walk closely alongside clients in guiding them throu ...
-
Case Manager
2 weeks ago
The Bradley Center Pittsburgh, United StatesSince 1905, The Bradley Center has continually served children and families in need. Today, the residential treatment facility provides 24 hour care and trauma-informed treatment to children who have a history of trauma and who may present with a wide range of challenges. · We ar ...
-
Case Manager
1 week ago
The Bradley Center Pittsburgh, United StatesJob Description · Job DescriptionSince 1905, The Bradley Center has continually served children and families in need. Today, the residential treatment facility provides 24 hour care and trauma-informed treatment to children who have a history of trauma and who may present with a ...
-
Case Manager
1 week ago
Light Of Life Rescue Mission Pittsburgh, United StatesJob Description · Job DescriptionSince 1952, Light of Life Rescue Mission has been a safe refuge for homeless and hurting people in the Pittsburgh area. The organization is currently seeking a full-time Parent & Child Case Manager to work in its Women & Children's Program. · This ...
-
Case Manager
1 week ago
Renewal Inc Pittsburgh, United StatesJob Description · Job DescriptionJob Title Case Manager · Reporting Relationship Case Management Supervisor · Work Schedule As per schedule (shifts and weekends); on call · Exemption Status Non-exempt · Grade I - IV · Definition · Provide guidance, direction, and management of ...
-
Case Manager
1 week ago
Light Of Life Rescue Mission Pittsburgh, United StatesJob Description · Job DescriptionSince 1952, Light of Life Rescue Mission has been a safe refuge for homeless and hurting people in the Pittsburgh area. · We currently seek a full-time Case Manager for the Women & Children's Longterm Program. This person will walk closely alongs ...
-
Case Manager
1 week ago
Duke Health Pittsboro, NC, United StatesAt Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. · About Duke Regional Hospital · Pursue y ...
-
Case Manager
1 day ago
Pennsylvania Associates LLC Aliquippa, United StatesJob Description · Job DescriptionCase Manager · We offer competitive salary, full benefits package, Paid Time Off, and opportunities for professional growth. · Pinnacle Treatment Centers is a growing leader in addiction treatment services. We provide care across the nation touchi ...
-
Case Manager
2 weeks ago
Adelphoi Village Inc Jeannette, PA, United StatesAdelphoi Village has a unique opportunity for a qualified professional interested in family and youth counseling in a foster care setting in Jeanette. This full time opportunity supports a single home that will have a dedicated foster parent temporarily caring for sibling groups ...
-
Case Manager
3 weeks ago
Sonova Pennsylvania, United StatesOur innovative hearing care solutions help millions of people enjoy life's unforgettable moments. · We offer exceptional career opportunities through market-leading brands from consumer to medical, products and services that keep pushing hearing care forward, and a culture where ...
Case Manager - Oakdale, United States - PAM Health
Description
Job Description
Job DescriptionCase Manager (RN)
The Case Manager is responsible for the interdisciplinary coordination of care for a designated patient population. The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Assesses and identifies discharge needs and coordinates appropriate discharge plan. Works collaboratively with the interdisciplinary team to facilitate achievement of desired financial and quality outcomes. The Case Manager will also maintain and enhance payor relationships. Performs other related duties as assigned or requested
RESPONSIBILITIES
Admission Data Collection and Assessment
Planning, Implementation & Facilitation
Advocacy
Monitoring & Evaluation
Professional Growth
QUALIFICATIONS
Education and Training: RN, OT, PT, SLP, RT or LSW licensure in state where the hospital resides required. Current BLS certification required.
Experience: Three to five years of inpatient experience, preferably in an acute, IRF or LTACH setting.
ABOUT US
PAM Health is committed to being the most trusted source for post-acute services in every community it serves by utilizing experienced and dedicated staff to provide high quality patient care and customer service. With over 44 Long Term Acute Care and Rehabilitation hospitals and 16 Outpatient Clinics currently in operation across the country, we are proud to offer services including comprehensive wound care, aquatic therapy, ventilator weaning, amputation treatment, pain management and much more.
Joining our PAMily allows you to work in a collaborative environment with colleagues and leadership with exposure to a variety of patient care levels. Aside from our competitive pay, generous paid benefit time, and excellent insurance options, you will also have opportunities for professional growth through our Education Advancement Program.
We are excited to learn more about you and hope that you consider joining us on a shared mission to improve the lives of others by being an integral part of our We Care Program. Please take a moment to visit us online at for a comprehensive look at how we're able to positively impact our local communities.
PAM Health does not discriminate and does not permit discrimination, including, without limitation, bullying, abuse or harassment, on the basis of actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status, or based on association with another person on account of that person's actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status.