Case Manager PRN

Kindred Hospital Dayton; Dayton (OH); On-site; USD 65,000 - 90,000; Full time

Job summary

Kindred Hospital Dayton coordinates and facilitates the care of the patient population through effective collaboration with the ICT team. This role ensures optimal resource use, service delivery and compliance with external review agencies across the continuum of care.

The position emphasizes discharge planning, care coordination, and comprehensive assessment to promote continuity of care and cost effectiveness while partnering with physicians, payors and post-acute providers.

Qualifications

• Education from an accredited school of nursing or social work.
• Experience in healthcare case management, utilization review, or discharge planning.
• Fluent in reading, writing and speaking English.
• Knowledge of government and payer practices, Medicare benefits and contracts.
• Ability to demonstrate critical thinking and prioritize tasks.

Responsibilities

• Coordinate clinical and psycho-social activities with the interdisciplinary team and physicians.
• Monitor patient stays to ensure effective care coordination and discharge planning.
• Conduct comprehensive discharge planning and timely post-hospital needs assessment.
• Participate in ICT rounds and conferences to review goals and optimize resources.
• Collaborate with payors, post-acute providers and families to support care transitions.
• Promote cost-effective utilization of clinical resources and services.

Skills

Care coordination

Critical thinking

Communication skills

Time management

Interdisciplinary collaboration

Microsoft Office

Education

BSN, MSN, BSW or MSW

Job description

Description

Kindred Hospital Dayton and Behavioral Health Unit (BHU) is a 97-bed hospital. With 51 long-term acute care hospital (LTACH) beds, we offer the same in-depth care you would receive in a traditional hospital, but for an extended recovery period. Our 46-bed behavioral health unit offers treatment for adults ages 18+, including dedicated services for geriatric patients. The unit offers 24-hour supervised psychiatric treatment and crisis support for mental health issues and like the LTACH, we partner with your physician and offer 24-hour clinical care seven days a week so you can start your journey to wellness. We are located downtown Dayton near the I-75 and I-35 junction, to the west of the Great Miami River.

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 Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.


• Monitors all areas of patients’ stay for 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.


• Enhances a collaborative relationship to maximize the patient’s and family’s ability to make informed decisions.


• Demonstrates knowledge 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 to review treatment goals, optimize resource utilization, provide family education and identified post hospital needs.


• Collaborates with clinical staff in the development and execution of the plan of care, and achievement of goals.


• Coordinates with interdisciplinary care team, physicians, patients, families, post-acute providers, payors, and others in the planning of the patients’ care throughout the care continuum.


• Discharge Planning Conducts comprehensive, ongoing assessment of patients to provide timely and safe discharge planning.


• Provide comprehensive discharge planning for each patient.


• Utilizes critical thinking to develop and execute effective discharge planning.


• Coordinate and communicates with patient/family efficient and effectively.


• Utilization Management Conducts medical necessity review for appropriate utilization of services from admission through discharge.


• Promotes effective and efficient utilization of clinical resources.


• Conducts timely and accurate clinical reviews, care collaboration and coordination of continued stay authorization with payor.


• Other Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.


• Serves on Hospital and Division committees when requested.

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.


• Ability to demonstrate critical thinking, appropriate prioritization and time management skills.


• 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.


• Approximate percent of time required to travel, 0% Must read, write and speak fluent English.


• Must have good and regular attendance.


• Performs other related duties as assigned.

Qualifications

Education

• From an accredited school of nursing in nursing or social work: BSN, MSN, BSW or MSW

Licenses/Certifications

• None Required

Experience

• Experience in healthcare setting in case management, utilization review, or discharge planning