Case Management

Outcome HC; Beachwood (OH); On-site; USD 55,000 - 75,000; Full time

Job summary

Outcome HC is seeking a dedicated Case Manager for a group of skilled nursing facilities. The role focuses on discharge planning, transition management, patient satisfaction, and readmission prevention, starting on admission and continuing through discharge.

You will work with the interdisciplinary team, patients and families to develop personalized transition plans, coordinating services such as transportation and home health, and participate in weekly utilization review meetings.

Qualifications

• At least 1 year full time experience in a sub-acute care setting.
• Familiar with hospital resources, community resources, and/or resource/utilization management.
• Care coordination, case management, discharge planning and/or utilization review experience.
• Effective decision-making /problem-solving skills, demonstration of creativity in problem-solving, and influential leadership skills.
• Excellent verbal, written and presentation skills.
• Moderate to expert computer skills.

Responsibilities

• Discharge planning and denial prevention, transition management to promote appropriate length of stay and prevent readmissions.
• Establish collaborative relationships with inter-disciplinary team, patients and families to develop comprehensive transition plans from admission to discharge.
• Assist clients in arranging services including transportation, housing, home health care services and other services as needed.
• Provide education and identify community resources for residents/clients.
• Represent campus and ensure continuity of care post-hospitalization up until discharge, coordinating with home health agencies, long-term care, medical transport, etc.
• Attend weekly utilization review meetings and monitor patient throughput.
• Implement and monitor processes to prevent payer disputes.
• Refer cases identified as risk management issues, peer review issues, or quality issues to appropriate team members.
• Monitor patient and family satisfaction; participate in departmental quality initiatives.
• Maintain clear communication with internal and external customers.

Skills

Care coordination

Case management

Discharge planning

Utilization review

Decision-making

Communication skills

Computer skills

Multitasking

Job description

Full job description

Looking for a Case Manager for a group of skilled nursing facilities. The candidate will be responsible for all activities related to Case Management, including, but not limited to, discharge planning, patient satisfaction, and denial prevention. Ensure transition management promoting appropriate length of stay, readmission prevention, discharge plan and patient satisfaction. Establish collaborative relationships with inter-disciplinary team, patients and families to develop comprehensive transition plans, starting on day of admission to the facility, to meet and identified goals.Candidate must have experience with understanding insurance benefits and possess an understanding of patients clinical charts.Assist clients in arranging services including transportation, housing, home health care services and other services as needed on an individual client basis.

Candidate Must Also:

• Provide patient and family education and identify community resources for the residents and/or clients.
• Serves as representative and resource for the campus and is the person ensuring the continuity of care post-hospitalization and up until the patient is discharged; includes, but not limited to, home health agencies, long term care, home health care service, medical adult day program, medical equipment companies and medical transport companies.
• Ensure timely and effective patient transition and planning to support efficient patient throughput and attending weekly utilization review meetings.
• Implements and monitors processes to prevent payer disputes.
• Refers cases identified as risk management issues, peer review issues, or quality issues to the appropriate team members.
• Monitors patient and family satisfaction through system approved measures, participates in the development and monitoring of any departmental quality initiatives.
• Exhibits clear communication skills with all internal and external customers. Maintains standards of behavior in interactions with all customers, coworkers, patients, visitors, physicians, volunteers, etc.
• Weekly follow up calls for discharged residents to ensure discharge plan was followed and no additional services are needed.

Education, Knowledge, Skills and Abilities Required:

• At least 1 year full time experience in a sub-acute care setting.
• Familiar with hospital resources, community resources, and/or resource/utilization management.
• Care coordination, case management, discharge planning and/or utilization review experience.
• Effective decision-making /problem-solving skills, demonstration of creativity in problem-solving, and influential leadership skills.
• Excellent verbal, written and presentation skills.
• Moderate to expert computer skills.

Candidate must be:

• Strong in multitasking
• Have the abilities to work under pressure
• Must be organized
• Must detail oriented
• Must me a strong team play and have strong communication skills