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Case Manager

THIS POSITION IS LOCATED AT MANGUM REGIONAL MEDICAL CENTER

Position Summary

A clinically competent Registered Nurse, Licensed Practical Nurse or Licensed Social Worker who is responsible for assisting in carrying out the hospital’s Case Management Plan. Educates staff regarding effective allocation of the Hospital’s resources while encouraging provision of high-quality patient care. Is cognizant of regulations and policies of all review organizations relating to billing of the fiscal intermediary’s coordinates, monitors and evaluates options in collaboration, and communication with other staff members. Assesses, plans, implements, coordinates, monitors, and evaluates options to facilitate the continuum of care.

POSITION SUMMARY EXPANDED:

Under the Oklahoma Medical Marijuana and Patient Protection Act, (“The Unity Bill”) this position is considered a “Safety-sensitive position. “Safety-sensitive” is defined to include “any job that includes tasks or duties that could affect the safety and health of the employee performing the task or others.” Employees working in “safety-sensitive” roles are subject to this exception and subject to disciplinary action in the event of a positive test for marijuana or its metabolites.

EDUCATION REQUIREMENTS

Graduate of an accredited school of nursing and possess current license in the State of Oklahoma.

Minimum of three (3) years acute hospital nursing or swing bed experience preferred and three (3) to five (5) years acute hospital or swing bed case management experience preferred.

Knowledge of theory, principles, techniques, and practice of professional nursing; of scientific principles and nursing research; of preparation, administration, and action of medications; of treatments and medical procedures; of counseling and teaching techniques; of medical equipment as it relates to patient care.

Emergency Room experience preferred.

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED

Licensed as an LPN, RN or Licensed Social Worker in the state of Oklahoma.

BLS certification required upon hire.

PALS preferred but not required.

- Proof of all required License(s) and Certification(s) is due at time of hire.

MINIMUM QUALIFICATIONS (KNOWLEDGE, SKILLS, AND ABILITIES)

Knowledge of the Continuum of Care and Utilization Processes

Knowledge of state and federal programs that provide medical care and financial support to individuals and community resources.

Ability to demonstrate clinical competence and maintain current knowledge in caring for pediatric through geriatric patients.

Ability to document care management plans in a clear and concise manner.

Ability to communicate effectively both verbally and in writing.

Ability to work with diverse patient and staff populations with knowledge and sensitivity to cultural and spiritual influences impacting on patient care.

Ability to work independently, with no direction.

ESSENTIAL DUTIES AND JOB RESPONSIBILITES

The essential functions include, but are not limited to the following:

To perform this job successfully, an individual must be able to perform each key function satisfactorily.

Each category will be assessed on performance measurements of appropriateness, efficiency, effectiveness, and timeliness.

Reasonable accommodations may be made to enable individuals with disabilities to perform the key functions.

Acts as a patient advocate.

Manage in a case management system using ongoing interaction with patients, physicians, and other health providers to meet designated clinical, operational, and financial outcomes for aggregate patient populations.

Maintains patient, employee, physician and corporate confidentiality, and respects the rights, privacy, and property of others.

Assists physicians, patients, families, staff, and payors in providing care for patient populations that is appropriate, effective, and cost efficient.

Ensures nursing care data is accurately documented in the patient care record.

Provides patients, families, and significant others with relevant health care education, instructions, and discharge planning.

Attend and actively participate in all departmental and interdepartmental meetings relative to Case Management/Social functions.

Collaborates with payors and review organizations to ensure proper utilization of patient care resources.

Collaborates effectively with patients, families, significant others, nurses, physicians, and other members of the health care team.

Participates in the review/revision of case management policies.

Documents clearly and concisely all contacts and information of the patient’s case management process on the appropriate chart forms.

Consistently presents a professional image and a caring attitude.

Exercises appropriate judgement and correct techniques in the performance of procedures, treatments, and drug administration.

Educates physicians and staff regarding appropriate level of care/utilization issues.

Demonstrates knowledge of disaster/emergency procedures and responds appropriately in emergency situations.

Demonstrates initiative in personal/professional development.

ADDITIONAL RESPONSIBILITIES

Seek out external resources through conferences, workshops, etc. as necessary.

Share professional knowledge with hospital staff, board members, and administrator.

Comply with HIPAA regulatory requirements.

Adhere to the hospital’s philosophy, mission, policies, and procedures.

Support the hospital’s goals and objectives.

Maintains a good attendance record and follows all hospital rules, policies, and procedures.

Maintains open and effective communications with patients and their nurses, physicians, peers, supervisors, and students. Establishes and maintains excellent interdepartmental and interpersonal relationships.

Attends departmental meetings and in-services to stay current with the developments of the department and hospital.

Observes that proper safety measures are enforced in the techniques used on patients receiving therapy. Maintains high safety standards in the hospital.

POSITION QUALIFICATIONS

INTERPERSONAL SKILLS

Demonstrates active listening techniques.

Gains support through effective relationships.

Treats others with dignity and respect; seeks feedback.

Demonstrates honesty and integrity at all times in care and use of patient and hospital property.

Demonstrates and understands the importance of and respect for the rights, dignity and individuality of each patient in all interactions.

Demonstrates respect for co-workers and responds to the needs of patients by complying with hospital policies.

REASONING ABILITY

Ability to apply common sense understanding to carry out instruction furnished in written, oral, and/or diagram form.

Ability to define and solve problems, collect data, establish facts, and draw valid conclusions.

Ability to interpret an extensive variety of technical instructions in statistical or diagram form and deal with several abstract and concrete variables.

LANGUAGE SKILLS

English is the primary language of the Hospital.

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.

Ability to interpret reports, business correspondence, and policy/procedure manuals.

Ability to effectively present information and respond to questions from groups of managers, physicians, clients, customers, employees, and the public.

MATHEMATICAL SKILLS

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.

Ability to compute ratio, percent, rate, as well as the ability to create and interpret graphs.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions. While performing the duties of this position, the employee is regularly required to work inside a clean, well-lit, and well-ventilated laboratory. While performing the duties of this position, the incumbent is regularly required to talk or hear. The employee frequently is required to use hands or finger, handle, or feel objects, tools or controls. The employee is occasionally required to stand; walk; sit; reach with hands and arms; climb or balance; and stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision and the ability to adjust focus. The noise level in the work environment is usually moderate. The employee may be exposed to some hazards such as radiation, bodily fluids that may contain disease, and fumes from laboratory chemicals.

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