Case Management Specialist - Relocation Offered!
The Case Management Specialist participates in a multidisciplinary team to coordinate high quality, cost efficient care for patients across the continuum.
Case management is achieved through a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet patients' health care needs through communication and available resources to promote quality cost-effective outcomes.
Education Associate's degree in Nursing Required and current Maryland RN license Required or Master's degree in Social Work Required and current Maryland Social Work License Required and BSN preferred for RN Preferred and Knowledge of Milliman and Interqual Required Experience 3-4 years Clinical experience in a related area.
Required and 1-2 years' Experience in case management or similar role Preferred or Licenses and Certifications Current BLS certification Required and Current case management certification Required Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards.
Complies with governmental and accreditation regulations.
Establish relationships with key personnel both within and outside St.
Mary's Hospital to promote effective communication and fully support coordination of care linkages and resource management for the patient and family Collaborate with the physician and health care team on level of care concerns and documentation of variances.
Demonstrate the ability to develop a plan of care that addresses needs across the continuum; have an intervention for each problem identified; develop long- and short-term goals with specific time frames for resolution; identify specific services to be provided in the care plan; include the family/care-giver in the plan of care; and show life planning contingencies such as power of attorney and/or advance directives.
Identify appropriate case management referral cases based on information collected from physicians, members of the health care team, families, review of the medical record and use of high risk screening criteria.
Identify barriers to high quality health care, such as the need for interpreter services and follows through with resolutions.
Perform detailed assessments of assigned cases that include:
Current health status of the patient including benefit coverage for all areas; Assessment of physical, psychological, and social needs of the patient; Identification of cultural influences on illness or injury; Identification of risks and hazardous home environments; and assessment of ability to perform activities of daily living and need for functional support.
Understand concepts of utilization management and able to determine level of care status and whether the documentation by physicians and health care team supports the level of care.
Assists with the development of departmental policies and procedures in support of clinical resource management.
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Estimated Salary: $20 to $28 per hour based on qualifications.
Case management is achieved through a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet patients' health care needs through communication and available resources to promote quality cost-effective outcomes.
Education Associate's degree in Nursing Required and current Maryland RN license Required or Master's degree in Social Work Required and current Maryland Social Work License Required and BSN preferred for RN Preferred and Knowledge of Milliman and Interqual Required Experience 3-4 years Clinical experience in a related area.
Required and 1-2 years' Experience in case management or similar role Preferred or Licenses and Certifications Current BLS certification Required and Current case management certification Required Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards.
Complies with governmental and accreditation regulations.
Establish relationships with key personnel both within and outside St.
Mary's Hospital to promote effective communication and fully support coordination of care linkages and resource management for the patient and family Collaborate with the physician and health care team on level of care concerns and documentation of variances.
Demonstrate the ability to develop a plan of care that addresses needs across the continuum; have an intervention for each problem identified; develop long- and short-term goals with specific time frames for resolution; identify specific services to be provided in the care plan; include the family/care-giver in the plan of care; and show life planning contingencies such as power of attorney and/or advance directives.
Identify appropriate case management referral cases based on information collected from physicians, members of the health care team, families, review of the medical record and use of high risk screening criteria.
Identify barriers to high quality health care, such as the need for interpreter services and follows through with resolutions.
Perform detailed assessments of assigned cases that include:
Current health status of the patient including benefit coverage for all areas; Assessment of physical, psychological, and social needs of the patient; Identification of cultural influences on illness or injury; Identification of risks and hazardous home environments; and assessment of ability to perform activities of daily living and need for functional support.
Understand concepts of utilization management and able to determine level of care status and whether the documentation by physicians and health care team supports the level of care.
Assists with the development of departmental policies and procedures in support of clinical resource management.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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