Clinical Case Manager

Clinical Case Manager Job Opening at James Square Syracuse

 

Exempt status, primarily Monday-Friday, days Must be available for on-call nights, weekends, and holiday when necessary as a part of a 24/7 health care facility. LPN or RN License and previous Long-Term Care/Rehabilitation experience.

Duties include:

• Assessing, monitoring, and re-evaluating assigned residents for nutritional status.
• Follow-up phone calls regarding bed vacancies to area discharge planners will be done in addition to the fax procedure.
• Must be organized and able to compile information quickly and efficiently so it can be relayed to the necessary parties timely (Admission Screeners and all necessary Departments as well as the corporate office).
• Will be knowledgeable in Medicare requirements and insurance providers, i.e. HMO rules, Medicare rules, RUGS II & Ill and Medicare D prescription plans.
• Insurance information is to be obtained when possible at the time a referral is called in. If insurance information is not available, the Screener will be notified to obtain information immediately and call/fax the information to the Admissions Director in order to obtain proper insurance verification.
• Admit patient to facility by having responsible party or resident sign admission packet within 48 business hours. Responsible for all census development and communication to the supervisory and Administrative staff.
• Maintain a sound filing system as devised with the supervisor.
• Utilize software to screen and develop admissions thoroughly vet properly individuals prior to admission to ensure the facility can clinically accommodate the level of care needed.
• Act as liaison between the facility and family members during the pre-admission and admissions process.
• Give tours when necessary.
• Upon admission, refer family members to appropriate Department Heads depending on specific needs, A log of all referrals in response to bed vacancies will be kept daily. This will be shared with the Admissions team and Administrators to assess response.
• Must be able to cope with the mental and emotional stress of the position.
• Ability to relate to and work with the ill, disabled, elderly, emotionally upset, and hostile individuals.
• At the time of admission, will meet with families with empathy to assure all necessary forms are completed and will coordinate with the Corporate Business Office to assure all necessary documents are received.
• Obtain the following information from all potential residents: PRI, completed admission application when applicable, bank statements and financial support statements if required and proper insurance verification.
• Will assure that all departments receive necessary information to prepare for admission (i.e.medications, treatments and any special needs).
• Promote and maintain a customer service approach at all times with empathy and a caring attitude.
• Must be punctual with good attendance.
• Must be flexible to allow for daily admissions.
• Will be on – call on a rotational basis with the other members of the Admissions Team.
• Adhere to all facility Policy and Procedures.
• Maintain confidentiality of all resident information.
• Ensure that the resident’s rights to fair and equitable treatment, self-determination, individuality, privacy, property and civil rights, including right to wage complaint, are well established and maintained at all times.
• Uphold and adhere to all department, facility and Corporate policies and procedures.
• Be able to generate necessary computer reports.
• Miscellaneous duties as required by facility.

 

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