Clinical Case Manager

County of DuPage; Wheaton (IL); On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

Medical insurance

Dental and vision insurance

Pension plan

Tuition reimbursement

Job summary

Kenneth Moy DuPage Care Center in DuPage County is seeking a Clinical Case Manager to provide professional case management for patients and clients, coordinating services, discharge plans, and communicating benefits and financial information.

The role requires collaboration with an interdisciplinary team to ensure timely discharges, accurate documentation, and advocacy for residents’ medical, social, and financial needs.

Qualifications

• Bachelor's degree in Social Work, Psychology, or related field.
• 1–2 years of experience within a skilled nursing facility working with Medicare/Medicaid populations.

Responsibilities

• Reviews and documents benefit, medical, social and financial information.
• Establishes contacts with family, payer and other internal and external customers.
• Develops and coordinates a safe, effective discharge plan with the interdisciplinary team.
• Maintains current documentation in medical records regarding discharge status and utilization reviews.
• Performs MDS 3.0 interviews and CAAs.
• Coordinates and facilitates interdisciplinary meetings.
• Supports transitions from community to skilled nursing facility.
• Advocates for residents and liaises with family.
• Conducts initial assessments including social history and trauma-informed care.
• Schedules and coordinates care plan meetings.
• Obtains authorizations for continued stay, procedures and tests as needed.

Skills

Patient advocacy

Care coordination

Interdisciplinary teamwork

Documentation skills

Communication

Education

Bachelor's degree in Social Work or Psychology

Job description

We are pleased to offer the opportunity to work as a Clinical Case Manager within Kenneth Moy DuPage Care Center. This position will provide professional clinical case management to patients and clients coordinating services, treatment status, discharge plans and communicating benefits and financial information.

DuPage County is an Equal Opportunity Employer

This position is eligible for our complete benefit package including medical, dental and vision insurance, flexible spending accounts, life insurance, pension, deferred compensation plan, tuition reimbursement, pre-paid legal and credit union. As a team member at DuPage County, you will also have access to time off with pay on Designated Holidays or holiday pay if required to work, Vacation time, Sick time and Paid Leave.

To learn more about the cost and coverage of the benefits plan, visit Employees Benefit Information.

For detailed information on paid time off, visit Employee Policy Manual, Section 5

Responsibilities Include:

• Reviews, assesses and documents benefit, medical, social and financial information in an accurate and appropriate manner.
• Establishes contacts with family, payer and other internal and external customers.
• Develops and works with the interdisciplinary team to coordinate a safe, effective, realistic and timely discharge plan and coordinates services and equipment needed for patients discharge.
• Develops and maintains current documentation in the medical records regarding status of discharge plans, case management authorizations and utilization review related to discharge.
• Conducts Minimal Data Set (MDS) interviews and completes assigned sections of MDS 3.0 including assigned Care Area Assessments (CAA)
• Works with the Interdisciplinary team to create a plan of care.
• Initiates contact with incoming long-term resident/patients and/or their initial contacts to have a dialogue about their transition from the community into a skilled nursing a facility.
• Provides ongoing support and advocacy for the resident and acts as a liaison to family.
• Completes initial assessments including social history, social services assessment and trauma informed care.
• Schedules and Coordinates care plan meetings.
• Obtains and documents authorizations for continued stay, procedures and tests ordered as medically necessary, per payer requirements.
• Coordinates completion of letters of medical necessity.
• Coordinates and facilitates interdisciplinary meetings.
• Assists in facilitating a smooth transition to alternative levels of care or discharge destinations.
• Assists in coordinating and facilitating patient/resident transitions within the Care Center to ensure continuity of care.
• Acts as a patient advocate utilizing internal or community resources to meet the residents medical, social or financial needs for discharge as well as for long term care patients.
• Conducts resident interviews for investigations.

Requirements include the following experience or equivalent combination of training and experience:

• Completion of a Bachelor's degree in Social Work, Psychology, or a related human service field
• One (1) to two (2) years of experience within a skilled nursing facility working with Medicare/Medicaid populations

Post-offer physical is required.

A pre-employment background check is required.

PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Light Work: Exerting up to 20 pounds of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Use of arm and /or leg controls requires exertion of forces greater than for sedentary work.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The work environment for this position regularly includes working with residents and attending to their daily needs. The noise level in the work environment is moderate to quiet.