Case Manager

Appalachian Regional Healthcare, Inc.

South Williamson, Kentucky

JOB DETAILS
JOB TYPE
Full-time
SKILLS
Case Management, Clinical Monitoring, Clinical Outcomes, Communication Skills, Cross-Functional, Data Analysis, Discharge Plans, Diversity, Government Regulations, Health Plan, Healthcare, Healthcare Quality, Hospital, Leadership, Multitasking, Nursing, Patient Assessment, Problem Solving Skills, Quality of Care, Registered Nurse (RN), Regulatory Requirements, Team Lead/Manager, Third-Party Payer, Time Management, Treatment Plan
LOCATION
South Williamson, Kentucky
POSTED
29 days ago
Overview:

The Case Manager is accountable for coordinating the care and service of selected patient population across a
continuum of care; ensuring and facilitating the achievement of optimal quality, clinical and cost outcomes;
coordinating services and resources needed by the patient and family; and assuming a leadership role with the
multidisciplinary team.

 

Special Instructions: Based mainly in the Emergency Department. Responsibilities:

Coordinates and collaborate with physicians, provider, multidisciplinary team and other health care professionals
concerning patient’s goals, plan of care and progress.
Develop, implement, interpret and maintain work standards and procedures that are in compliance with ARH’s
policies and governmental regulations and various regulatory agency requirements.
Maintain up-to-date knowledge in the field to allow recommendation of new services, products and equipment.
Assesses, develop, implementation, and monitors comprehensive plan of care through an interagency multidisciplinary team process in conjunction with the patient and family internal and external settings.
Revise and adjust on a daily basis the plan of care to accommodate the needs of the individual patient based on
continuing assessment of patient condition.
Assumes responsibility and accountability for the care plan and effectiveness and patient outcomes.
Assesses the appropriateness of the level of care; diagnostic testing and clinical procedures; quality and clinical
risk issues; and documentation of medical record completeness.
Develop, implement, monitor and evaluate clinical pathways and clinical pathway variances.
Monitor patients' progression through clinical pathways.
Communicates continually with patients, families, medical staff, caregiver and third payors as necessary.
Assist the patients and families with the educational process prior to admission, during hospital stay and after
discharge, as indicated.
Assures patients understand the third-party payer guidelines and to arrange discharge planning referrals as
ordered by patients’ physicians.
Develops and maintains a positive work climate and supports the overall team effort of the hospital.
Assists in collecting and analyzing outcome data.
Performs other duties as assigned or directed.

Qualifications:

Education (experience can be substituted for education)
Associate's Degree Nursing Preferred

 

Work Experience (education can be substituted for experience)
4-6 years Preferred

 

Knowledge, Skills and Abilities
Advanced knowledge of problem solving and decision making skills.
Strong multi-tasking abilities with the ability to handle competing deadlines; flexible and adaptable.
Ability to deal tactfully with customers and community.
Advanced communication skills used to lead a team.
Advanced execution and delivery (planning, delivering, and supporting) skills.
Ability to consider the relative costs and benefits of potential actions to choose the most appropriate one.
Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients.
Mastery knowledge of phases of care transitions and resources available for patients.
Mastery of digital literacy skills.
Ability to handle sensitive information ethically and responsibly.

 

Licenses and Certifications
Registered Nurse Preferred
LPN Required

About the Company

A

Appalachian Regional Healthcare, Inc.