Inpatient Case Manager

Fully Remote

Monday-Friday 8am-5pm

Description:

Job Summary:

Responsible for working collaboratively with physician partners to optimize quality and efficiency of care for hospitalized members by carrying out daily utilization and quality review, monitoring for inefficiencies and opportunities to improve care, developing a safe discharge plan to include recommending alternative levels and sites of care when appropriate. The activities will include daily review of hospital care by chart review and discussion with attending physician, admission and concurrent review for inpatient admissions, meetings with patient and families to develop discharge planning, identification of patients for ambulatory case management, communication with case managers, home care reviewers, social workers, members and providers, quality improvement reviews, and education of the member/family, provider and hospital staff. Achieves desired utilization and quality outcomes and promotes high customer satisfaction to the population served.

Essential Responsibilities:

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of appropriate, individualized plans of care to ensure continuity, quality and appropriate resource use. Reviews, monitors, evaluates and coordinates the patient's hospital stay to assure that all appropriate and essential services are delivered timely and efficiently. Communicates via huddles with hospitalist partner multiple times throughout the day.Reviews all new inpatient admissions within 24 hours and begins the discharge planning process immediately. Assesses high risk patients in need of post-hospital care planning. Develops and coordinates the implementation of a discharge plan to meet each patient's identified needs; communicates the plan to physicians, patient, family/caregivers, staff and appropriate community agencies to enhance the effect of a seamless transition from one level of care to another across the continuum. Ensures that the appropriate level of care is being delivered in the most appropriate setting. Recommends alternative levels of care and ensures compliance with federal, state and local requirements.Performs psychosocial assessments on all patients that meet the high risk indicators for discharge planning. Comprehensively assesses patients' goals as well as their biophysical, psychosocial, environmental, economic/financial, and discharge planning needs. Provides patients with education to assist with their discharge and help them cope with psychological problems related to acute and chronic illness. Refers patients to the ambulatory case managers, care managers and/or social workers as appropriate. Documents all admissions and discharges in the patients electronic medical record. Makes post discharge follow-up calls to all patients who are not referred to an ambulatory case/care management program.Attends scheduled rounds 2 times/week with the Physician Director of Resource Stewardship to discuss clinical course and discharge planning for assigned patients identifying any real or potential delays in care or quality of care issues.Acts as a liaison between inpatient facility and referral facilities/agencies and provides case management to patients Serves as an advocate for patients and families. Coordinates transfer of patients to appropriate facilities; maintains and provides required documentation. Builds highly effective working relationships with physicians, SNF staff, vendors, and other departments within the health plan.

Skills

Case managementInpatientHospitalMedical CenterRN licenseCare management

Pay and Benefits

The pay range for this position is $40.00 - $50.00

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

Hiring diverse talent Maintaining an inclusive environment through persistent self-reflection Building a culture of care, engagement, and recognition with clear outcomes Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.