Experience
- 5 years of relatedexperience.
- Case managementutilization review or discharge planning experience in an acuterehabilitation skilled nursing or outpatient setting is required.
Preferred
- Health plan experience in utilization review and case management willbe considered.
Licensure
- Currentunrestricted license to practice in Massachusetts in a health or human servicesdiscipline that allows the professional to conduct an assessment independentlyas permitted within the scope of practice of the discipline. Examples areNursing Physical Therapy Occupational Therapy Speech/Language PathologyLCSW Respiratory Therapist or Rehabilitation Counselor.
Skills(Specificlearned activity gained through training (e.g. computer skills keyboardingpresentation CPR ACLS etc.
- Certification in CaseManagement preferred.
- Knowledge of communityservices and the healthcare systems required.
- Knowledge of criteria andlevels of care is desirable.
- Computerproficiency required. Microsoft officeapplications preferred with ability to learn new software.
Preferred- Highlydeveloped communications and interpersonal skills working with diversepopulation.
- Workindependently be selfdirected and contribute as a member of a team.
- Anticipateschallenges and develops and implements strategies for addressing them.
- High level of service delivery.Demonstrate initiative with ability to prioritize work meet deadlines andadapt to changing situations.
- Attentionto detail.
Facilitatethe coordination of care from admission through discharge with focus onrealistic treatment outcomes within the scope of available resources. Overseethe assessment planning facilitation coordination evaluation and advocacyfor options and services to meet a patient and familys comprehensive healthneeds and to promote quality cost effective outcomes. Collaborate with the interdisciplinary teampatient and family as well as various departments within and outside thehospital to assure timely and appropriate discharge planning and cost effectiveoutcomes.
- Assessmentof the patients health and psychosocial needs is conducted per establishedguidelines.
- Casemanagement plan is developed collaboratively with the interdisciplinary teampatient and family to maximize health care responses quality and costeffective outcomes incorporating patient and family goals expectations andpreferences into the development of the interdisciplinary plan of care
- Communicationand coordination is actively promoted between members of the interdisciplinaryteam the payer and the community to minimize fragmentation of services and tomaximize outcomes.
- Patientcentered team meetings are planned and conducted to coordinate healthcare teammembers and third party payers to achieve treatment outcomes and dischargeplanning goals
- Educationis provided to the interdisciplinary team the patient and the family abouttreatment options community resources insurance benefits and psychosocialconcerns to ensure timely and informed decisions.
- Patientand family are empowered to problem solve to achieve desired outcomes andpromote patient self determination.
- Appropriateuse of health care services and allocation of resources is encouraged toimprove quality of care and maintain a balance with cost effective care on acase by case basis.
- Appropriateresources are identified to provide discharge services and promote a safetransition to the next most appropriate level of care.
- Dischargeplan is developed in collaboration with healthcare team and family and meetspatient needs and financial requirements.
- Culturallycompetent care is displayed to identify the patients cultural needs andincorporate them in the development of the discharge plan.
- Patienteducation and support is provided to ensure a smooth transition from acutesetting through the SRN stay and transition to discharge using establishedstandards.
- Documentationis completed in adherence to department standards.
- Thirdparty coverage guidelines are adhered to for each patient situation.
- Additionaldepartment organization or network activities are completed per establishedobjectives.
- PCCOrganizational Values of Innovation Collaboration Accountability Respectand Excellence are upheld.
SRN is committed to diversity in the workplace which begins with respect and opportunity for all. PHH takes affirmative action to ensure that equal employment opportunity is provided to all persons regardless of race religious creed color national origin sex sexual orientation gender identity genetic information age ancestry veteran status disability or any other basis that would be inconsistent with any applicable ordinance or law.Required Experience:
IC