- Coordinating patient care plans, including admissions, discharge planning, and transfers, by liaising with all necessary care providers and medical professions to ensure patients' needs are met.
- Responds to patient referrals from outside facilities referral of potential patients in a timely manner
- Cultivate referral relationships, manage assigned territory, and complete patient assessments.
- Review of medical records in support of patient admissions
- Complete face to face initial assessments while considering acuity, services, equipment, and medical needs of the patient to determine their eligibility.
- Work with Hospitalist regarding inpatients and potential referrals to Swing bed.
- Must be able to work with insurances on authorizations and in house coding and financial department to assist with the documentation needed for efficient processes for billing and payment.
- Collect and input patient data, insurance information and financial information into computer system.
- Case management resource for ED patients
- Use computer software for admissions and discharge planning of patients, coordinate follow-up appointments, and referrals as needed.
- Identification of patients that meet criteria of Swing bed and Skilled Nursing
- Collect, compile, and evaluate data daily to identify and track potential candidates for return to inpatient and/or outpatient services.
- Consult with patient, family, and Discharge Planners at facilities where patients are hospitalized regarding Swing bed.
- Meet with patients and patient families to ensure patient needs are being met and resolve any issues or complaints that arise
- Educate qualified patients and their family members or caregivers of our services.
- Provide feedback and recommendations for program developments and quality improvements related to customer service and referral source satisfaction.
- Stay up to date with organization communication and directive.
- Adhere to all policies of the organization, including (but not limited to) job description, certification/licensure requirements, mission statement, HIPAA, confidentiality standard and patient's rights.
- Other duties as assigned.
- RN or LPN state license
- Bachelor's degree program in Nursing preferred
- Excellent computer skills
- Superior interpersonal communication skills and the ability to exercise empathy when working with patients and their families
- Strong organizational and time management skills
- Demonstrate an understanding of standard clinical procedures, laws, and regulations
- Thorough knowledge of medical terminology
- Resourceful self-starter, works well independently as well as part of a team
- Must possess a valid driver's license and show proof of insurance
- Ability to speak a second language is an asset
- 3+ years of Case Management or Clinical Management experience
- Computer and Printer
- Copy Machine
- Fax Machine
- Telephone
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case manager - Cleveland, United States - Cleveland Area Hospital Inc
Description
Job Description
Job DescriptionPOSITION SUMMARY:
Case Managers and Clinical Coordinators are part of day-to-day operations in healthcare. They act as a liaison between patients, patient families, and health care professionals throughout the treatment process. These positions coordinate the admission of new patients to the hospital or other medical facilities. Case Managers and Clinical Coordinators possess RN or LPN licensure and have prior experience working in clinical settings. It is imperative that they have exceptional communication skills as they are tasked with interacting with a wide range of individuals each day. They must also have a strong understanding of medical terminology and excellent organizational skills to ensure that the needs of all patients are being met.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function
PRINCIPAL JOB DUTIES AND RESPONSIBILITIES:
EDUCATIONAL/SKILLS REQUIRED:
EXPERIENCE:
EQUIPMENT:
RESPONSIBILITY FOR CONFIDENTIAL INFORMATION:
This position could have access to patient confidential records and must comply with HIPAA regulations as well as Compliance Policies.
The above statements reflect the general details considered necessary to describe the principal function of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent to this position.
