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An established industry player is seeking a Clinical Case Manager to enhance patient care efficiency and ensure smooth transitions from inpatient to outpatient settings. This role involves coordinating care, monitoring patient needs, and collaborating with healthcare teams to provide comprehensive management. The ideal candidate will possess a Bachelor's degree in a health-related field, with a preference for those holding a Master's degree and RN licensure. If you are passionate about improving patient outcomes and have a strong clinical background, this opportunity could be a perfect fit for you.
Scope of Position/Position Summary:
The Clinical Case Manager facilitates an assigned group of patients through the health care system with the primary focus of efficient, effective, compassionate inpatient care and a safe transition to the outpatient setting. In some areas, this may include pre-admission to post-discharge coordination of care. The Clinical Case Manager monitors the patient care process and physiological needs; documents, communicates, and collects data to evaluate and improve the timeliness and appropriateness of care. The Clinical Case Manager collaborates with physicians, nurses, and other health care workers to provide comprehensive disease management assessment, treatment, and follow-up evaluation for patients, and to communicate the plan of care. The Clinical Case Manager maintains awareness of state and national health care trends and proactively responds with initiatives to enhance the provision of care and ensure efficient resource utilization. The Clinical Case Manager works closely with the Resource Case Manager(s) and Utilization Case Manager.
Minimum Qualifications:
For Hire: Bachelor's degree in a health-related field of study or social work, with hospital discharge experience or an equivalent combination of education and experience; Master's degree preferred. RN preferred or other professional healthcare licensure; five years of recent clinical experience applicable to the population preferred; knowledge of evidence-based practice and disease-specific processes; technology support and payer protocols desired.