Case Manager

Location: Troy, MI
Date Posted: 11-16-2017
About us:
Morgan Stephens represents the nation’s top healthcare systems offering the highest compensation and benefits to our top candidates.   We are created and managed by experienced industry professionals in healthcare. As a leading provider of contract, contract to perm, and direct placement recruiting services to healthcare organizations throughout the United States, we have successfully served the needs of our employees and clients by placing thousands of quality healthcare professionals into organizations seeking top talent.
 
Open Position:
The Case Manager is responsible for compliance with CMS Conditions of Participation regarding Utilization Review and Discharge Planning including implementation and annual review of the Utilization Management Plan and assisting with the coordination of the Utilization Management Committee. The Case Manager is also responsible for ensuring compliance with provisions of care regarding discharge planning and patient needs for care, treatment, and services after discharge or transfer are met. The Case Manager follows the hospital's Case Management/Utilization Program that integrates the functions of utilization review, discharge planning, and resource management into a singular effort to ensure, based on patient assessment, care is provided in the most appropriate setting utilizing medically indicated resources. The hospital’s case management model outlines a collaborative practice to improve quality through coordination of care impacting length of stay, minimizing cost, and ensuring optimum outcomes.

ESSENTIAL FUNCTIONS:
Promote the mission, vision, and values of the organization
Facilitate team meetings that foster interdepartmental collaboration with the patient and their family as deemed necessary, this includes multidisciplinary meetings and Utilization Review/Case Management meetings. Provides input in such meetings regarding utilization management and discharge planning.
Responsible for evaluating and screening potential admissions to the facility when appropriate.
Knowledgeable of criteria for Medicare, Medicaid, HMO and private insurance coverage.
Communicate daily with admissions personnel regarding admissions and discharges to various units.
Initiate ongoing communication with the resident and resident’s family to assess discharge needs.
Communicate with physicians to ascertain their plans for a timely discharge.
Document discharge planning as an ongoing review.

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