This position is located in Jasper North Georgia Mountains 60 miles from Atlanta. The Case Manager is responsible for the coordination of care across the continuum during the patient's acute, chronic, and long-term stages of illness for a defined patient population, which includes neonate pediatric, adolescent adult, and geriatric. This includes utilization management (including utilization review, obtaining pre-certification and concurrent review authorization of admission and continued stay from commercial payers and/or Medicaid, and Medicare reviews), transitional care (Discharge) planning, psychosocial and functional status assessment, patient advocacy, education for the patient/family, complex case management, and monitoring value indicators to demonstrate outcomes resulting from the services provided. Collaborates with the patient, the family, other case managers, physicians, nurses, and other health care disciplines, and the patient's reimbursement plan to provide a comprehensive assessment of a given patient's plan of care, goal/outcome attainment, and continued care needs. The staff member must be able to demonstrate the knowledge and skills necessary to provide care based on physical, psychosocial, educational, safety and related criteria, appropriate to the age of the patients served in his/her assigned position. The skills and knowledge needed to provide such care may be gained through education, training or experience. Minimum Qualifications: Registered Nurse with Georgia licensure or bachelor of Social Work Degree or registered. Respiratory Therapist with Georgia licensure, Patient Care Assessor Certification, and a Bachelor of Science Degree. A minimum of three (3) years of clinical practice/experience is required. Organization, prioritization, verbal, interpersonal, customer relations, mathematical, analytical, grammar/spelling, read and comprehend written instructions, follow verbal instructions, basic computer skills, and data processing. Preferred Qualifications: Experience with Clinical Documentation Management preferred. |
