Case Manager PRN

At ScionHealth , we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.

Job Summary

Coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs. Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.

Essential Functions

Care Coordination

• Assist in coordinating clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians. • Assists with effective care coordination and efficient care facilitation. • Remains current from a knowledge base perspective regarding reimbursement modalities, community resources, case management, psychosocial and legal issues that affect patients and providers of care. • Appropriately refers high risk patients who would benefit from additional support. • Serves as a patient advocate. • Knowledgeable of the principles of growth and development over the life span and the skills necessary to provide age-appropriate care to the patient population served. • Participates in interdisciplinary patient care rounds and/or conferences. • Collaborates with clinical staff in the execution of the plan of care, and achievement of goals. Discharge Planning • Under appropriate supervision, conducts comprehensive, ongoing assessment of patients and family to provide timely and safe discharge planning. • Assists with comprehensive discharge planning. Utilizes critical thinking to execute effective discharge planning. Utilization Management • Conducts medical necessity review for appropriate utilization of services from admission through discharge. • Promotes effective and efficient utilization of clinical resources. • Conducts timely and accurate clinical reviews, care collaboration and coordination of continued stay authorization with payor.

Other

• Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards. • Serves on Hospital and Division committees when requested.