Case Manager (PRN) - Case Management - Weekdays and Weekends

Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Provisional Level 1 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 910 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.

The Case Manager is responsible for performing Case Management and discharge planning activities. The Case Manager helps to facilitate timely and efficient throughput of patient care. The Case Manager coordinates with physicians, staff and other healthcare providers regarding patient care. The Case Manager provides effective hospital case management and discharge planning to assure that the patient progresses through the continuum of care and is discharged to a safe and appropriate discharge environment based on physician order. The Case Manager works as a member of the interdisciplinary team to coordinate post hospital care arrangements and provides psychosocial support and assistance to patients and families such that patients move through the continuum of care in a safe and timely manner. The Case Manager performs initial inclusive assessment; develops and refines individualized discharge plan; effectively manages barriers to discharge; responds to emotional factors; maintains knowledge of and connects patients with appropriate post-hospital community resources and services; advocates for patients’ rights including self-determination; collaborates with and facilitates communication among care providers; documents in the medical record and in computer systems in a concise and timely manner; adheres to organizational policies and procedures, regulatory accrediting body requirements, and professional practice standards. The Case Manager performs other duties as required or assigned, whether for emergency or operational reasons, for which the employee is qualified to perform.

People At The Heart Of All We Do

• Fosters an inclusive and engaged environment through teamwork and collaboration.
• Ensures patients and families have the best possible experiences across the continuum of care.
• Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.

• Behaves in a mindful manner focused on self, patient, visitor, and team safety.
• Demonstrates accountability and commitment to quality work.
• Participates actively in process improvement and adoption of standard work.

• Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
• Knows and adheres to organizational and department policies and procedures.

• Actively participates in team development, achieving dashboards, and in accomplishing department goals and objectives.
• Proactively assesses and re-assesses patients and families for psychosocial, discharge planning, and financial needs so that an age/need appropriate discharge plan is developed per departmental protocols. Initiates appropriate and complete referrals to post-acute care services and providers in a timely manner. Post-acute care providers include and are not limited to SNFs, home health agencies, hospices, LTAC’s, DME companies and community resources, through the development of collaborative relationships and in compliance with departmental protocol and hospital policy.
• Coordinates details of final discharge disposition so that discharge is safely achieved without avoidable delays and to the satisfaction of the patient, family and care team.
• Properly and accurately documents in the medical record per departmental protocol and hospital policy. Identifies and includes in this documentation the patient needs, plans, current status, financial/insurance information and interventions.
• Demonstrates comprehensive knowledge of and completes effective referrals to resources addressing the financial aspect of patient care including KEPRO, financial eligibility vendors, indigent medication programs, and other financial resources.
• Communicate and work collaboratively with physicians, hospital staff, payers, and other external and internal vendors, so that expected patient and program outcomes such as appropriate utilization of services, levels of care, and alternative discharge arrangements are achieved.
• Plan and prioritize work in such a manner as to achieve departmental objectives and individual productivity targets while functioning as a team member and responding to patient needs in areas regularly assigned and throughout the hospital as needed. Performs related documentation per departmental protocol.
• Demonstrate quality work through adherence to applicable hospital Case Management standards and by exhibiting reliability, accuracy and responsibility in all aspects of their work.
• Contribute to development of the Case Management Department and Revenue Cycle by increasing and sharing knowledge and skills which include required education, in-services, department meetings, formal and informal education, as well as review of hospital policies and procedures.
• Maintains consistent and reliable attendance and complies with hospital policy related to attendance.
• The Case Manager performs other duties as required or assigned, whether for emergency or operational reasons, for which the employee is qualified to perform.
Demonstrates professionalism by being punctual and dependable.

Essential:

• Excellent organizational and prioritization skills. Good communication and interpersonal skills in dealing with patients, center leadership, physicians, staff, payers, service providers, and community agencies. Knowledge of discharge planning, community resources, case management and processes, managed care systems and regulatory requirements. Capable of medical record review, analysis and interpretation of insurance plan benefits, and contracts. Basic computer skills.
• Ability to effectively interact with patients, families, physicians, co-workers and community agencies.
• Ability to organize and prioritize multiple requests and duties.
• Excellent communication skills with a collaborative approach and work style.
• Understanding of the psychosocial issues, behavior in crisis situations, and range of responses to illness and disability.

Essential:

• Bachelor Degree

Essential:

• Bachelor degree from an accredited school of social work or related field. Bachelors in psychology or sociology and with some health care experience.