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Form of workPositions Location: Ionia, MI Job Description General Purpose of Job: Effectively manages and coordinates the patient's plan of care across the continuum. Works collaboratively with the interdisciplinary team enhancing the quality of patient clinical outcomes and patient satisfaction with efficient and effective utilization of resources. Serves as a clinical resource to patients, families and staff in the coordination of care to all patients.
Essential Duties: This job description is intended to cover the minimum essential duties assigned on a regular basis. Caregivers may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.
Psychosocial Assessment and Interventions: Conducts a preliminary risk screening, assesses patients and family's psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, reaction to illness and ability to cope. Performs comprehensive assessments of patients' medical condition, adjustment, support systems, finances, housing, behavior, cognition, abuse factors, function and abilities, legal, and substance abuse factors to identify issues, which must be addressed prior to discharge. Provides intervention in cases involving child abuse/neglect, domestic violence, elderly abuse, institutional abuse and sexual assault.
Serves as a resource person and provides counselling and intervention related to treatment decisions and end-of-life issues. Develops long and short-term plans with the patient/family to address problems identified. Provides emotional support to help patients cope with the disruptions and distresses associated with their illness/injury.
Observes patient's right to self-determination and confidentiality. Intervenes with problems of: Adult Abuse, Suicide, Guardianship, Conservatorship, Durable Power of Attorney, and Mental Illness. Care Coordination: Coordinates and facilitates patient care progression throughout the continuum.
A collaborative process that encompasses the following: assessment, plans, implements, coordinates, monitors and evaluates the options and services required to meet the needs of the patient. Works collaboratively and maintains active communication with other members of the interdisciplinary team to effect timely and appropriate patient management. Proactively identifies and resolves delays and obstacles to discharge.
Collaborates with the interdisciplinary care team facilitating care for the designated case load; monitors the patient's progress with the appropriate interventions ensuring a focused plan of care and services are provided while providing high-quality cost-effective care. Facilitates transfers to other facilities as appropriate. Provides the appropriate patient follow up in compliance with regulatory agencies and hospital policies and standards.
Utilization Management: Identifies at-risk populations using approved screening tool and follows established reporting procedures. Effectively works with the community to identify and allocate post discharge needs Monitoring - utilizes all relevant resources to gather sufficient information regarding the effectiveness of the plan Apply clinical screening criteria Deliver accurate clinical picture to 3rd party reimbursement Assist in appealing admissions that payors deny. Understand how to confirm the insurance coverage for each potential patient, understands the approval criteria/process for each payer, and assures that applicable approvals are obtained and documented appropriately Monitors and facilitates the length of stay and ancillary resource use.
Takes the appropriate actions to achieve the continuous improvement in both length of stay and resource utilization. Self-directed and organized to meet the needs of the patient and the health care team. Other duties as assigned pertinent to scope of job.
Communication: Provides clear, concise, and timely written documentation. Communicate and provide information to post-acute care providers and payers ensuring adequate resources are provided to the patient. Communicates effectively and navigating conflicts with patients, families, members of the care team in a diplomatic and empathetic manner.
Negotiation with clinical departments and payers, advocating for the patient; transitioning them to the next phase of care. Job Requirements General Requirements Current SW License Current Michigan RN Licensure and CRRN Exam eligible (Certified Rehabilitation Registered Nurse - Certified through Association of Rehabilitation Nurses), or State of Michigan PT licensure, or State of Michigan OT licensure and registered as an Occupational Therapist by the National Board for Certification in Occupational Therapy Inc, or State of Michigan Speech-Language Pathology licensure and Certificate of Clinical Competency in Speech/Language Pathology from the American Speech-Language-Hearing Association, or State of Michigan PTA licensure Certification in Case Management preferred BLS preferred Work Experience Minimum one year of inpatient experience in an acute care or rehab setting. Education Master's degree in Social Work or Graduate of an accredited Associate Degree in Nursing and/or currently enrolled in BSN program or Graduate of an accredited school of Physical Therapy or Graduate of an accredited school of Occupational Therapy or Master's Degree in Speech/Language Pathology from an accredited program in Speech/Language Pathology or Graduate of a Physical Therapist Assistant or Occupational Therapy Assistant program Specialized Knowledge and Skills Familiarity with resources available for use in assessing regulations and the parameters of third-party reimbursement Maintains an environment that supports and encourages high performance and reliability through caregiver engagement, teamwork, and customer service ensuring safe quality patient-centered care.
Possess excellent verbal and written communication skills. Promotes individual professional growth and development by meeting the requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization. Demonstrated expertise in decision making, time management, oral and written communication, and computer use.
Ability to work independently and exercise sound judgement in interactions with physicians, payers, patients and their families. Demonstrates ability to use a keyboard as may be required to perform the essential duties of the job. Experience in acute care case management, discharge planning, utilization management, performance improvement and managed care reimbursement preferred Sparrow Health System is an Equal Opportunity/Affirmative Action employer.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.
