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Case Manager
Job Title:
Case Manager - Case Management - Full-Time - DaysReq:
2026-0182Location:
HospitalDepartment:
Case ManagementSchedule:
day with rotation to weekend and holidays
Job Description:
- PURPOSE OF THE JOB:
- ESSENTIAL FUNCTIONS
- Discharge Planning: Discharge planning is an on-going process that will require the case manager to evaluate and re-evaluate the patient's needs daily or when indicated via interview process and chart review. Discharge planning starts at time of admission and a tentative discharge plan will be addressed in the patient's medical record within 24-48 hours after admission. Assessment and evaluation of the patient needs will be conducted by reviewing current and prior functioning, psycho-social dynamics, and identification of support system. The discharge plan is developed in collaboration with the multi-disciplinary team which may include the payer and will include active input from the patient and/or family. Identification of barriers must be considered in order to facilitate a smooth and successful transition to the next level of care. The case manager will address issues with prior plan of care, specifically with regards to readmissions.
- Implementation and facilitation of care activities: The case manager will act in a proactive manner addressing real and potential issues with the development and implementation of the plan of care. Documentation of the case manager's activities and discussions should be outlined in the patient's medical record. This might include but is not limited to reaching out to external stakeholders such as the primary care provider and requesting assistance with the development of the plan of care. The purpose would be to overcome any identified barriers to care with the goal being to achieve a successful outcome for the patient. Additionally, the case manager should be verifying benefits and securing authorizations from the payer as indicated and documentation should include facilitation of necessary community resources as needed.
- Data Collection: Case Manager will participate in the collection of information regarding quality improvement activities, risk management issues and reporting this information through appropriate committee structure.
- Behavioral Expectations: Exhibit consistent professional conduct in interaction with patients/families, medical staff, payers and peers while also respecting HIPAA requirements. Takes ownership for errors and takes immediate corrective action when indicated.
Job Qualifications:
QUALIFICATIONS
When considering candidates the manager will take into consideration the overall dept skill set and can choose from one of three levels of clinicians for this role acknowledging each discipline will require various levels of supervision and support based on their education, experience and other skills. Disciplines to consider are Registered Nurse, Master Level Social Worker and Bachelor level in Social Work or related field.
Education:
Registered Nurse: must have a current license in Pennsylvania from the Commonwealth of Pennsylvania, Department of State Bureau of Professional and Occupational Affairs. Bachelor degree preferred.
Master Level Social Worker: Master of Social Work degree from CSWE accredited school. LCSW preferred.
Social Worker: Bachelor of Social Work or related field from an accredited school.
Experience:
Registered Nurse: a minimum of three or more years of acute care clinical nursing. Recent experience in a hospital, insurance company, or independent review company in utilization, quality review, home care or case management.
Master level Social Worker: a minimum of three or more years in the acute care setting. Previous social work experience or internship in an acute care hospital setting.
Social Worker: a minimum of three or more years in the acute care setting. Previous social work experience or internship in an acute care hospital setting.
Other Skills:
General Skills All Disciplines: Excellent verbal and written communication skills. Strong organizational and prioritizing skills. Thorough understanding of managed care systems and utilization review criteria. Knowledge of community resources. Demonstrated leadership abilities. Experience in the use of information systems. Must be able to manage and perform well under stress.
Certification and Licensure:
All disciplines (RN, MSW and BSW) prefer Certification in Case Management (CCM) which reflects advanced education, practice and work experience.
Registered Nurses prefer a Bachelor degree in Nursing.
Master's level Social Worker prefers LSW or LCSW. Licensure and certification demonstrates a higher level of commitment to their profession and experience through internship and mentoring by another higher level clinician.
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