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The Access Case Manager (CM), under the direction of the Director/Manager of Case Management functions as a member of the interdisciplinary healthcare team in the provision of patient care with the underlying objectives of enhancing the quality of clinical and financial outcomes and patient satisfaction while managing the plan of care. Within the purview of financial management, pro-actively communicates with members of the healthcare team to ensure appropriate medical necessity for patients in beds; Serves as an effective liaison to ensure continuity and integration of services and accurate assignment of patient status. Communicates with payers and patient/family/healthcare team regarding payer information as necessary. Ensures that patient care moves through the continuum in a timely and efficient manner.
Job Responsibility:
Accepts responsibility and accountability for achievement of optimal outcomes within their scope of practice
Follows policies, procedures and standards
complies with Corporate Compliance program
Assumes responsibility for risk and safety issues associated with the position
Takes call as required by the department expectations
Performs specific job responsibilities and demonstrates accountability for own actions and decisions
Acquires and maintains knowledge and competence related to the expectations of their position and practices within their scope
Brings ideas and concerns to supervisor, participates in department decision making
Maintains current licensure
Performs high level screening, assessment, and planning to enhance and support Direct Admission, Transfer Center, and procedural area patient flow
Appropriately screens patients for level of care (LOC) and ensure clinical information in the medical record is clear and accurately reflects LOC requested
Partners with medical staff to improve overall quality of the clinical documentation and establish accurate assignment of patient status orders (e.g., Observation/Inpatient)
Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department
Requirements:
Bachelor Degree Nursing
2 or more years clinical experience
Licensed Registered Nurse (LRN) - Single State - State Board of Nursing Registered Nurse in State of Kansas
Nice to have:
Master Degree Nursing
2 or more years clinical experience in health care setting