Case Manager - Full Time Days

ScionHealth; Green Cove Springs (FL); On-site; USD 60,000 - 80,000; Full time

Job summary

ScionHealth seeks a Care Coordinator to manage patient care across the continuum through collaboration with the ICT team and care providers. You will oversee assessment, planning and evaluation to optimize resources and outcomes.

You will coordinate with physicians, payors and social services, ensuring compliant, cost-effective discharge planning and ongoing care management. A background in nursing or social work supports licensure requirements and team-based care.

Qualifications

• Graduate of an accredited program: LPN/LVN or RN.
• MSW with licensure as required by state regulations; or Bachelor of Social Work with licensure.
• One year of experience in healthcare; case management, utilization review, or discharge planning a plus.

Responsibilities

• Coordinate clinical and psycho-social activities with Interdisciplinary Team and physicians.
• Support care coordination and efficient facilitation of care.
• Refer high-risk patients for additional support as needed.
• Serve as a patient advocate and communicate with hospital leadership, payors and families.
• Participate in interdisciplinary rounds and conferences; collaborate to achieve care goals.

Skills

Medicare knowledge

Payor practices

Regulatory compliance

English fluency

Microsoft Office

Interpersonal skills

Written communication

Attendance

Education

LPN/LVN or RN

MSW (Licensure)

BSW (Licensure)

Tools

Microsoft Office

Job description

Description

At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.

Job Summary

Coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs. Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.

Essential Functions

Care Coordination

• Assist in coordinating clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
• Assists with effective care coordination and efficient care facilitation.
• Remains current from a knowledge base perspective regarding reimbursement modalities, community resources, case management, psychosocial and legal issues that affect patients and providers of care.
• Appropriately refers high risk patients who would benefit from additional support.
• Serves as a patient advocate.
• Knowledgeable of the principles of growth and development over the life span and the skills necessary to provide age-appropriate care to the patient population served.
• Participates in interdisciplinary patient care rounds and/or conferences.
• Collaborates with clinical staff in the execution of the plan of care, and achievement of goals.

Knowledge/Skills/Abilities/Expectations

• Knowledge of government and non-government payor practices, regulations, standards and reimbursement.
• Knowledge of Medicare benefits and insurance processes and contracts.
• Knowledge of accreditation standards and compliance requirements.
• Must read, write and speak fluent English.
• Basic computer skills with working knowledge of Microsoft Office, word-processing and spreadsheet software.
• Excellent interpersonal, verbal and written skills in order to communicate effectively and to obtain cooperation/collaboration from hospital leadership, as well as physicians, payors and other external customers
• Demonstrates good interpersonal skills when working or interacting with patients, their families and other staff members.
• Must have regular attendance.
• Approximate percent of time required to travel, 0%.
• Performs other related duties as assigned.

Qualifications

Education

• Graduate of an accredited program required: LPN/LVN or RN.
• Master of Social Work with licensure as required by state regulations; or Bachelor of Social Work with licensure as required by state regulations.

Licenses/Certification

• Healthcare professional licensure required as LPN/LVN, Registered Nurse, or Licensed Clinical Social Worker (LCSW) or Licensed Social Worker (LSW) if required by state regulations.

Experience

• One year of experience in healthcare setting.
• Experience in case management, utilization review, or discharge planning a plus.