Integrated Case Manager

Integrated Case Manager

Meta Sense Inc.

Join to apply for the Integrated Case Manager role at Meta Sense Inc.

$67.41/hr - $67.41/hr

THIS IS A STRIKE CONTRACT; ONCE THE STRIKE IS COMPLETE, THE RATES WILL BE AS FOLLOWS:

• Traveler: $58 - $62/hour
• Local: $50 - $55/hour

• Minimum 5 years acute inpatient case management experience (acute discharge planning)
• MLSW certification
• BLS certification through AHA
• Previous experience using Care Port system
• Willing and able to be on the floor with patients and acclimate quickly
• Candidates must be MLSW certified; experience charting in AllScripts, GEMS/Sunrise preferred

Job Summary

The Integrated Case Manager for Population Health is an interdependent member of the patient-centered care team responsible for assessment, planning, facilitation, care coordination, evaluation, and advocacy to meet individual and family health care needs. The role addresses the needs of patients following critical events or diagnoses that require complex management strategies and extensive resources to optimize health outcomes across the care continuum.

Services are provided to patients from ambulatory, inpatient, or health plan settings.

• Conduct a comprehensive assessment of the patient and family/caregiver of biomedical, psychological, social, and functional needs to gauge recovery impact.
• Develop personalized patient-centered care plans to optimize care experience.
• Engage patients and families in the care team through advocacy, ongoing communication, health education, and resource facilitation.
• Use professional judgment, critical thinking, motivational interviewing, and self-management techniques to help patients overcome barriers to goal attainment.
• Provide counseling and interventions related to treatment decisions and end-of-life issues, including Advanced Care Planning.
• Coordinate transitions to ensure patients move safely between care settings.
• Advocate for appropriate delivery of services within the patient’s health plan benefit structure.
• Collaborate with the treatment/care team to co-manage patients with complex medical and social needs, facilitating interdependent collaborative care conferences.
• Continuously evaluate the patient’s response to the care plan, making modifications when necessary.
• Plan and participate in process improvement activities to reduce risk, including data collection, analysis, and follow-up interventions.
• Facilitate interventions in cases involving child abuse and neglect, domestic violence, elder abuse, institutional abuse, and sexual assault.
• Support department-based goals contributing to organizational success.
• Perform other duties as assigned.

• Excellent verbal communication and written documentation skills.
• Excellent customer service and interpersonal skills, including the ability to interact with internal and external customers at all organizational levels.
• Strong problem-solving, analytical, and decision-making skills.
• Strong computer skills and knowledge.
• Preferred experience in discharge planning, home health care, rehabilitative medicine, community health or managed care.
• Knowledge of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations, and case management principles.
• Understanding of medical ethics and legal implications related to case management.
• Understanding of social determinants of health and their impact on patient wellbeing.
• Well versed in facilitating community resources to meet the needs of diverse populations.
• Strong organizational, planning, and implementation skills with the ability to handle multiple complex patient needs simultaneously.
• Strong sense of compassion and ability to advocate for patients and their families.

• MSW

• Registered Nurse (RN) with a valid, unrestricted State of Michigan license.
• Licensed Social Worker (LMSW) with a valid, unrestricted State of Michigan license.

Associate

Contract

Other

Hospitals and Health Care