Case Manager

Job Summary:
Responsible for the functions of case management and discharge planning.
Essential Values-Based, Leadership and Management Competencies:
Demonstrates competencies in line with the five core values that are the foundation of all activities performed by employees in order to achieve the Mission of Artesia General Hospital

• Respect:Demonstrates competence in respect for others.
• Leadership:Demonstrates competence in knowing everyone has a role.
• Professionalism:Demonstrates competence in the conduct, aims and qualities of health care.
• Dedication:Demonstrates competence in dedication to Artesia General Hospital.
• Commitment To Excellence:Demonstrates competence in expecting nothing less than "DOING THE RIGHT THING".

ESSENTIAL FUNCTIONS:

• The Case Manager is responsible for establishing and maintaining open, effective communication between facility and referring publics, consumers, physicians, and third party payers.
• Determines Patient medical eligibility, qualifying diagnosis, and determines Medicare/Managed Care eligibility based on skilled services provided.
• Identifies and plans strategies to reduce in-patient length of stay and resource consumption.
• Provides patient/ family with information about home health care, skilled nursing facilities, rehabilitation facilities and appropriate providers.
• Maintains availability to the patient/family as a resource to facilitate communication among providers and to monitor services rendered.
• Maintains active communication with members of the multidisciplinary care team to effect timely and appropriate patient care and facilitate discharge.

ADDITIONAL RESPONSIBILITIES:

• As assigned.

KNOWLEDGE/SKILL/ABILITIES:

• Maintains knowledge of regulatory agencies and managed care entities concerning levels of care, continuity of benefits, and medical necessity guideline.
• Demonstrates the willingness to research, learn, and obtain knowledge for the performance of the position.
• Basic computer.

AGE-RELATED COMPETENCIES: Demonstrates the basic knowledge and skills necessary to identify age-specific patient needs appropriate for this position.
Information Management: Treats all information and data within the scope of the position with appropriate confidentiality and security.
Risk Management/Quality Management/Safety: Cooperates fully in all Risk Management, Quality Management, and Safety Activities and Investigations.
MINIMUM POSITION QUALIFICATIONS:

• Education -Graduate from an accredited school of nursing; BSN preferred.
• Work Experience - Five years position-related experience in a healthcare-related field.
• Training - N/A
• License/Certification - Current New Mexico Nurse License. Certification in case management preferred.

ENVIROMENTAL CONDITIONS: Work environment consists of daily patient contact, which may include exposure to blood, or other body fluids.