Case Manager

We are looking for a dedicated and compassionate Case Manager to join our interdisciplinary team. The Case Manager will be responsible for assessing, developing, implementing, and monitoring comprehensive care plans for patients and their families in various settings.

Essential Job Functions

• Assess patients’ healthcare needs and develop comprehensive care plans.
• Facilitate communication between patients, families, and healthcare providers.
• Coordinate transitions between care settings, ensuring continuity of care throughout the treatment process.
• Evaluate medical necessity for treatments, procedures, and hospital stays.
• Collaborate with insurance companies to obtain authorizations.
• Monitor length of stay and identify potential discharge barriers.
• Ensure appropriate use of healthcare resources and advocate for patients’ needs and preferences.
• Educate patients and families about diagnoses, treatments, and self-care practices.
• Connect patients with community resources and support services.
• Address barriers to care, including financial, social, and logistical hurdles.
• Regularly review and update care plans based on client progress.
• Facilitate referrals to specialized services, including housing, healthcare, and legal aid.
• Represent client interests within complex service systems.
• Ensure clients receive entitled benefits and services while maintaining accurate case management records.
• Document assessments, interventions, and outcomes.
• Track quality metrics and patient outcomes, preparing reports for healthcare teams and administration.
• Work collaboratively with physicians, therapists, social workers, and other healthcare team members.
• Participate in interdisciplinary care conferences and consult specialists regarding complex patient needs.
• Support the mission, vision, and values of the organization.
• Participate in required education and training programs as applicable.
• Perform other related duties as assigned.

Qualifications

• Education: Graduate of an accredited school in medicine, social work, nursing, or a related medical field is required. Preferred candidates will hold a BSN or MSN and have experience coordinating community resources for post-acute hospitalization care.
• Licenses/Certifications: Active RN license is required; CRASE training is necessary for travel assignments extending beyond six months.
• Experience: Previous clinical experience in acute care or home health setting assessing skilled care needs is required. Experience in Discharge Planning and/or Case Management is preferred.
• Skills: Bilingual candidates, particularly those who are English-Spanish speaking, are preferred. Ability to work effectively with a culturally diverse population is essential.

Physical Requirements

Essential functions of this position require sufficient auditory ability to detect and respond to various sounds, clear communication skills, visual acuity for observing patient conditions, and tactile perception for assessing physical characteristics during patient care. The ability to perform tasks requiring motor coordination and to lift and position patients is necessary, with expectations for safe lifting techniques and appropriate mechanical aids.

Working Conditions

This position is primarily performed in an indoor healthcare environment. Staff may experience variable indoor temperatures and are required to follow safety protocols to minimize exposure to infectious materials. The role demands the ability to respond quickly to changing circumstances and may involve managing multiple simultaneous demands in a fast-paced environment.