Complex Care Manager Job at Stamford Hospital
The Care Manager is responsible for coordinating the care delivered to an assigned group of patients with complex care needs. Assesses plans and evaluates the outcomes of care in collaboration with the other members of the health care team. Guides and collaborates with health care team members within the continuum to ensure quality and cost-effective care is given within a timely manner and a safe post- acute plan is facilitated. Monitors the plan of care with the patient/family and includes their input for appropriate effectiveness of care. The Care Manager supports the needs of the department based on organizational needs.
MAJOR ACCOUNTABILITIES/CRITICAL RESPONSIBILITIES:
- Works in conjunction with assigned social worker/case manager coordinating complex patient care throughout the continuum of care among the interdisciplinary team for identified population with a focus on complex LOS issues, readmission and high utilizers of the ED. Attends LOS and complex care weekly meetings in the hospital units.
- Provides ongoing assessment and case management of identified patient population to ensure an accurate evaluation of patient needs, appropriate level of care, proper resource utilization, and quality of care and risk management in post-acute setting. Develops and documents goals for patient outcomes based on assessment within identified time and documents in clinical records as indicated with the assigned Case Manager and Social Worker.
- Maintains a patient log of patients, monitors and evaluates the plan of care on an ongoing basis. Revises goals as needed.
- Assures compliance with level of care requirements relative to all payer types and contract requirements in post-acute settings in identified population. Assures compliance with federal, state and local requirements e.g. ADA, Workman’s Compensation, EMTALA.
- In coordination with social work/case management maintains ongoing communication regarding patient care with physicians, referral sources, caregivers, patients, etc. to facilitate, coordinate, and ensure appropriate transition of care. Communication is effective and clear while following identified population in post-acute setting.
- Independently initiates assessments of situations, identifies and explores alternatives and chooses appropriate course of action in areas within scope of practice.
- Acts as an advocate for individual’s health care needs. Identifies barriers and advocates for patient to access to care. Identifies and intervenes system problems within the acute care system as well as the community which are barriers to timely care.
- Establishes communication system with payers to determine benefit eligibility. Maintains knowledge of payer requirements.
- Responsible for maintaining a professional relationship with referral sources and community resources and participating in local professional organizations and activities.
- May conduct visits in the field, home, skilled nursing facility, doctor’s office, etc. when needed to assess and/or evaluate patient’s needs or environment of care.
- Provides patients and families support, information and education about their current disability.
- Provides education and support to hospital staff regarding community resources, managed care issues, or payment payer issues.
- Demonstrates an ability to be flexible, organized and functional under stressful situations. Utilizes critical thinking and problem solving skills and sound judgment in priority setting and delegation.
- Practices autonomously, consistent with evidenced-based standards. Pursues personal and professional growth and development.
- Creates and maintains a calendar of activities and presents at department meetings.
- Complies with hospital policies and procedures.
- Performs other related duties as assigned or requested in order to maintain a high level of service.
Required Skills
Professional certification in case management or clinical specialty is highly desirable. BSN needs to be registered in the state of Connecticut. Social work license for LMSW is preferred.
Provide copy of valid driver’s license.
Required Experience
QUALIFICATIONS/REQUIREMENTS:
Bachelors prepared Registered Nurse or MSW licensed in the state of Connecticut. LMSW is preferred. Strong clinical experience in an acute care setting with additional experience in home care, long term care and case management is preferred. Professional certification in case management or clinical specialty is highly desirable.
Must have a car with minimum car insurance coverage of $100,000/$300,000 or $300,000 if single coverage and provide certificate of insurance.
Strong organizational and communication skills are essential.
Completes required department and organization training and education in a timely manner.
Demonstrates professional work behavior by following Service Standards and Success factors.
Complies with departmental organizational policies and procedures and adheres to external agency requirements.
Please Note :
ajayjain.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, ajayjain.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.