Case Manager

Job type: Full Time shifts per two week pay period. Rotating weekends required.

The individual in this position is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination.  The individual in this position has overall responsibility to assess the patient for transition needs including identifying and assessing patients at risk for readmission. Conducts complex psycho-social assessment and interventions to promote timely throughput, safe discharge and prevent avoidable readmissions.  This position integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction Care Coordination by demonstrating efficient throughput  while assuring care is sequenced and provided at the appropriate level of care   Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy Education provided to physicians, patients, families and caregivers Provides educational programs for Case Management Department on community resource use in discharge planning  Provides reports to Director of Case Management and hospital leadership as requested Provides management of the department, but not limited to, hiring/training/managing staff, schedule coordination, analysis and reporting, interfacing, collaborating and working closely with the other departments This individual’s responsibility will include the following activities: a) complex psycho-social transition planning assessment and reassessment and intervention, b) assistance with adoptions, abuse and neglect cases, including assessment, intervention and referral as appropriate to local, state and /or federal agencies, c) care coordination,  d) implementation or oversight of implementation of the transition plan, e) leading and/or facilitating multi-disciplinary patient care conferences including Complex Case Review, f) making appropriate referrals to other departments, g ) communicating with patients and families about the plan of care, h) collaborating with physicians, office staff and ancillary departments, i) assuring patient education is completed to support post-acute needs , j) timely, complete and concise documentation in Tenet Case Management  documentation system, k ) maintenance of accurate patient demographic and insurance information, l) and other duties as assigned.