The Case Manager functions as a member of both a unit-specific and an organization-wide team promoting excellent overall care management of patients admitted to the hospital in either inpatient or observation status. The Case Manager combines their professional knowledge base and experience with critical thinking skills and an organized, team approach to support the delivery of effective and efficient patient care. Accountable for the utilization management, care coordination, and discharge planning for patients within the assigned case load.
Provides patient care, treatment, and services within the scope of their license, certification, registration, and/or assessed competencies. Practice will be in accordance with laws and regulations and will adhere to established policies, procedures and practice guidelines.
Maintains accountability for facilitating clinical patient progression through a defined plan of care to achieve optimal outcomes.
Integrates the nursing process (assess, plan, implement and evaluate) and a quality management process (plan, do, check, act) as the framework for decision-making and problem solving.
Utilizes professional knowledge to facilitate a physician-specific plan of care, ensure appropriate resource utilization, and coordinate utilization review and approval by payers.
Supports and coordinates discharge planning services.
Acts as an effective member of an interdisciplinary team in improving quality, service, and financial aspects of overall patient care management.
Participates in continuous quality improvement teams and activities.
Participates in supporting the organization’s vision, mission and values and adheres to DeKalb Medical Standards of Behavior.
Performs other duties as assigned to meet the goals and objectives of DeKalb Medical.
Minimum Education, Experience and Licensure Required:
Bachelor’s degree in Nursing (BSN) required
Current Georgia Licensure as a Registered Nurse
Minimum of two (2) years recent acute care experience required, with relevant clinical experience in the assigned area
Case Management Certification preferred
Skills, Knowledge and Abilities:
High degree of self motivation and directional initiative.
Excellent customer service skills and strong drive to provide compassionate care.
Critical thinking skills, decisive judgment and the ability to work with minimal supervision in a fast paced environment.
Strong communication skills with ability to effectively communicate technical information to patients and families.
Ability to effectively manage multiple tasks and priorities within a fast-paced environment.
Ability to collaborate effectively with multidisciplinary healthcare teams.
Must be able to perform skills and competencies as defined in orientation checklist and annual departmental competency checklist if applicable.
Demonstrates and maintains competencies specific to patient population served.
Reports to: Manager, Care Management; Daily oversight and guidance from Lead Case Manager
Positions Supervised: Care Management Interns