Case Manager - Per Diem

The Case Manager

Responsible and accountable for the coordination of patient services through an interdisciplinary process, providing a clinical and psychosocial approach throughout the continuum of care. The case manager assesses patients to determine appropriateness of admission, continued hospitalization, and appropriate level of care. Discharge planning begins at admission or prior and is reassessed throughout hospitalization. Quality and risk management issues are monitored and reported.

The case manager may be assigned to various units throughout the hospital or the Emergency Department.

Required to work one weekend shift every two weeks. Other days as needed.

Qualified candidates must live in the Boulder, CO regional area and be willing to work onsite at a hospital facility (not a remote work-from-home position).

• Integrate the assessment of the need for post‑hospital services and determine an appropriate discharge plan for complex cases.
• Educate patient and family on options/choices within the level of care determined to be appropriate and initiate and ensure completion of all necessary paperwork.
• Facilitate completion of orders as required prior to transfer of patient to the next level of care in a timely manner so discharge is not delayed.
• Continuum of Care planning emphasizes education and collaboration with physicians, family members, clinical social workers, nursing staff, therapists and case managers from contracted payors to determine a discharge plan that offers maximum benefit to the patient. Involve staff from the next level of care in the treatment plan as early as possible to promote continuity and collaboration.
• Report all relevant information to the staff assuming responsibility in the next level of care.
• Employees are expected to comply with all regulatory requirements, including CMS and Joint Commission standards.
• Maintain knowledge of all applicable federal and state regulations and demonstrate a working knowledge of managed care and Medicare health plans as well as reimbursement related to post‑acute services within the Continuum of Care.
• Consult with physician section leaders for support in cases where continued stay is not appropriate, and case managers are unable to resolve the issue by working with the assigned physician.
• Communicate with the department director, LOS and financial information, and issues that may affect the Continuum of Care process.
• Remain flexible to meet the needs of the hospital, including floating to other departments as patient needs fluctuate.
• Review the patient plan of care with the multi‑disciplinary team. Facilitate and participate in multi‑disciplinary team care conferences for patients with complex problems. Communicate in the medical record and verbally with the team to coordinate interventions and facilitate continuity of care.
• Daily communication and collaboration with patient care staff to provide continuous assessment, evaluation and continuum planning to assure the patient receives the appropriate level of care at the appropriate time.
• Coordinate patient care processes to achieve desired quality outcomes and identify/control inappropriate resource utilization.
• Facilitate patient and family education and promote continuity of care to achieve optimal patient outcomes. Ensure patient rights by offering choice when appropriate.

• Adhere to name badge/dress code compliance.
• Effectively solve problems and actively pursue resolution.
• Directly communicate with staff, physicians, patients and families in a professional and courteous manner.
• Role model leadership behavior through courtesy, respect and efficiency.
• Function without direct supervision, utilize time constructively and organize assignments for maximum productivity. Arrange schedule to facilitate meetings with physicians for patient care rounds, team meetings and other opportunities to improve communication.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be…