AddressGENERAL SUMMARY:
The Case Manager is an interdependent member of the patient-centered care team or treatment team responsible for the collaborative practice of the following:
· Assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet an individual's and family's comprehensive health care needs though communication and available resources to promote patient safety, quality of care and cost-effective outcomes.
· Addresses the needs of patients who have experienced a critical event or diagnosis that requires complex management strategies and the extensive use of resources to optimize health outcomes along the care continuum.
· Provides services to patients from ambulatory, inpatient or health plan settings.
EDUCATION REQUIRED:
· Bachelor's degree in nursing or related professional field (i.e., social work, counseling, health education, etc.)
or
· Master's degree of Social Work. Minimum (3) three years of clinical experience.
EXPERIENCE REQUIRED:
· Excellent verbal communication and written documentation skills.
· Excellent customer service and interpersonal skills including the ability to interact with internal and external customers and all levels of the organization.
· Strong problem-solving, analytical, and decision-making skills.
· Strong computer skills and knowledge.
· Experience in discharge planning, home health care, rehabilitative medicine, community health or managed care preferred.
· Knowledge of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles.
· Knowledge of medical ethics and legal implications related to case management.
· Understanding of social determinants of health and their impact on a patient's wellbeing. Well versed in facilitating community resources to meet the needs of diverse populations.
· Strong organizational, planning and implementation skills with the ability to handle multiple complex patients' needs simultaneously. Strong sense of compassion with the ability to successfully advocate for patients and their families.
CERTIFICATIONS/LICENSURES REQUIRED:
· Registered Nurse (RN) or a Licensed Social Worker (LMSW) with a valid, unrestricted State of Michigan license.
· Certification in Case Management (CCM) by the Commission for Case Management Certification (CCMC) or Accredited Case Manager (ACM) by the American Case Management. Required within three (3) years of hire.
