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Case Managers (CM)

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As a Case Manager (CM) he/she will be required to acquire recorded history of his clients by discussing their needs and problems, and guides them to meet those needs and/or end results. After researching all about the clients' history and background, manner of thinking, capabilities, and other important things; the case manager puts forth a wide range of choices that would help client alleviate their problems.

The Case Manager then guides his clients to choose the most appropriate one according to their needs. Note: The CM does not take decisions and make choices on behalf of his clients.

He/she will report to the Director of Case Management for guidance, leadership and case support as well as daily interventions that assist all CM’s in training protocols. The CM will be assessed for clear, concise oral and written presentation skills to executive and senior staff members periodically.

On the medical side of case management, this professional assesses the veteran's mental and physical condition and discusses associated problems and treatment options with doctors. He also consults with the veteran's family members regarding what all things they need to do for making the life of the veteran. He has to make every possible resource available that will be beneficial for his client's well being. He acts as a liaison between service providers and recipients.

CASE MANAGER QUALIFICATIONS:

There are some prerequisites that you should possess before entering the field of case management. You may be required to have a BS or an MS in mental health, social work, or any such related section of study. Some entities may even offer you employment on the basis of an AS degree. Additional education or knowledge of criminal justice, human resources, and health care is truly valuable in a career as a case manager. You should also possess good oral and written communication skill, interpretation capabilities, counseling techniques, problem-solving skills, and appropriate decision-making skills.

To provide ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs.

The overall goal of the position is to enhance the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integrating and functions of case management, utilization review and management and discharge planning.

Has accountability for the care, coordination and assessment planning of all veterans. This position is accountable to the Director of Case Management.

QUALIFICATIONS:

Associate degree in healthcare or social work related field. Bachelor’s and/or advanced degree preferred.

Bachelors or Masters Degree in related healthcare field (such as respiratory therapy or social work) may be considered. Minimum of two (2) years of utilization review/case management experience or social work experience. Minimum of one (1) year experience in discharge planning from a hospital is preferred. Maintain current professional licensure in nursing or professional field of certification. Appropriate certification in case management preferred (e.g., Commission for Case Management Certification (CCMC).

SUMMARY OF MAJOR AND ESSENTIAL FUNCTIONS:

Provides veteran case management/utilization review planning to assure that the veteran progresses through the continuum of care and is assessed for employability of various assignments within the organization.

Coordinate the integration of the social service function of veteran care. Coordinates the case activities concerned with case management and discharge planning. Adhere to departmental goals, objectives, standards of performance, and policies and procedures. Ensure compliance with quality patient care and regulatory compliance.

DUTIES AND RESPONSIBILITIES:

  • Coordinate the integration of social services/case management functions into the patient care, discharge, and home planning processes with other hospital departments, external service organizations, agencies and healthcare facilities.
  • Conduct concurrent medical records review using specific indicators and criteria as approved by medical staff, JCAHO, CMS, and other state agencies.
  • Acts as veteran advocate: investigates and reports adverse occurrences, and performs staff education related to resource utilization, discharge planning and psychosocial aspects of healthcare delivery.
  • Promotes effective and efficient utilization of clinical/veteran resources.
  • Mobilizes resources and interviews, as needed, to achieve expected goals to assist in achieving desired clinical outcomes within the desired timeframe.
  • Ensure that patient tests are appropriate and necessary and are carried out within the established timeframe and that results are promptly available.
  • Conducts review for appropriate utilization of services from admission through discharge. Evaluate veteran assessment satisfaction and quality of care requested.
  • Initiates and presents “referral letters”, as appropriate.
  • Assesses veteran care required throughout continuum of care for diagnosis/prognosis, procedures and DRG’s.
  • Communicates with intake staff/intakes coordinators at regular intervals throughout the initial screening and develops an effective working relationship. Assist department heads to maintain appropriate cost, case, and desired veteran outcomes.
  • Introduces self to veteran and family members by explaining intake/employment case manager role and process for veteran and family to contact case management.
  • Complete expanded assessment of client/veteran and family needs at time of intake. Complete psychosocial assessment.
  • Assess veteran progress through specific hospitalization care as needed.
  • Refers cases where veterans and/or family would benefit from counseling required to complete complex issues to social worker.
  • Serve as a veteran advocate. Enhances a collaborative relationship to maximize the veteran as well as the family’s ability to make informed decisions.
  • Facilitates interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified post-hospital needs.
  • Collaborate with clinical staff in the development and execution of the plan of care, and achievement of goals.
  • Directs and participates in the development and implementation of veteran care policies and protocols in order to provide advice and guidance in handling special cases or family needs.
  • Coordinates the provision of social services to veterans, families, and significant others to enable them to deal with the impact of illness on individual family functioning and to achieve maximum benefits from healthcare services, etc.

 

Please e-mail your resume to Dr. Works with the word "Resume" on the subject line and the position you are applying for. All positions are for current and former military veterans only.

 

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