Supervision: Provides leadership and accountability for case management/social work staff. Identifies opportunities to improve the internal/external world class customer service, and outcome metrics within quality management. Coaches and mentors case management staff to increase knowledge, practice, efficiency, while striving for excellence with the services they provide resulting in desired outcomes/metrics.
Collaboration: Integrates patient information from social worker, physician and other members of the healthcare team to collaboratively determine potential and actual risks to recovery and the next level of care. Collaborates with physicians, nursing, social work, and multiple disciplines, departments, payer, agencies to eliminate barriers to efficient delivery of care in the appropriate setting.
Planning: Accountable for developing and coordinating the implementation of a safe and timely discharge plan and alternative plan following evidence based practice.
Assessment: Confers with attending physician/LIP as appropriate to make determination about the medical necessity for admission or continued hospital stay. Performs assessment to determine patient care needs during the acute phase of illness and post discharge needs.
Coordination/Facilitation: Coordinates and facilitates access to services and patient care progression using best practice interventions that will produce favorable patient outcomes within a target LOS.
Documentation: Documents patient interventions and outcomes in the medical record in a timely and accurate manner.
Regulation: Uses the Physician Advisor per protocol for complex issues related to physician practices and utilization review.
Required: 5 years’ experience working in an acute care setting
Preferred: Experience as a community health nurse or case manager