Case Manager - PSH

Job Description

Job Description

Title: Case Manager

General summary

The primary purpose of your job position is to coordinate delivery of services to managed care and Medicare patients in collaboration with the hospital’s team members. The Case Manager monitors and documents the cost effectiveness of treatment provided, facilitates and coordinates the admission and discharge process, serves as the patient and family advocate and acts as a liaison to insurance and medical management professionals.

Duties and responsibilities

Our primary focus at Pioneer Specialty Hospital is to deliver exceptional care that exceeds in safety, quality, and patient satisfaction. We are committed to serving our patients and families to provide the best medical care possible. Our dedicated team of physician, nurse, and clinicians are committed to each patient as an individual.

We strive to be the preferred provider in the industry of long-term acute care by providing professional post-acute care services that are safe, effective, and efficient. Our goal is to consistently exceed the expectation of our patients, their families, and referring physicians.

Responsibility to coordinate clinically complex patient’s care across a continuum; ensuring and facilitating the achievement of quality clinical and cost outcomes, negotiating, procuring and coordinating appropriate services and resources needed by the patients, and at key points, intervening to address and resolve issues/concerns. Key in ensuring appropriate sequencing of treatment goals and implementation of a comprehensive discharge plan. Demonstrate knowledge and skills necessary to provide case management services to the patient population ranging in age from 18 years to geriatric experiencing medically complex conditions, general medical-surgical conditions with rehabilitation and wound care needs.

Responsibilities:

• Facilitate case management
• Provide education, support and training to patients, families, employees and medical staff on case management function
• Work closely with Admissions and/or other financial staff to formulate plan of care for pre-certification of potential admission. Review pre-admission screening for utilization review, funding and discharge planning issues
• Initiate discharge planning activity at the time of admission. Determine discharge care needs through assessment and interdisciplinary team membership. Determine need for home evaluation and, as appropriate, initiate referral to selected community care agencies providing information pertinent to continued care needs in a timely and organized manner
• Maintain excellent working relationship with the medical professional and other health related facilities and organizations.
• Demonstrate and understand the importance of and respect for the rights, dignity, and individuality of each patient in all interactions.
• Demonstrate satisfactory level of interpersonal skills to interact and deal tactfully with facility staff, Administration, patients, families, customers, vendors, and government agencies.
• Responsible for traveling between both facilities - Pontiac and Garden City
• Must have RN license
• Case Management Experience required