Case Manager

This position performs a major role in the monitoring and evaluation of patient care practices. This person assists in meeting the psychosocial needs of patients and provisions of discharge planning services to patients and their families with personal or environmental difficulties which may interfere with obtaining maximum benefits from medical care, assuring timely discharge and effective post-hospital care. This person must be able to apply the six essential activities within the five core components of: Coordination and Service delivery; Physical and Psychological factors; Benefits systems and cost benefit analysis; Case management concepts; and Community resources. The six essential activities are: Assessment, Planning, Implementation, Coordination, Monitoring and Evaluation. These core components and essential activities must be applied across a continuum of care that addresses the ongoing needs of the individual being served by case management process, and deal with the person’s broad spectrum of needs. Reviews all denials and appeals decisions as appropriate. Performs insurance pre-certification and updates. Assist physicians with coordination of patient care serving as Physician assigned case managers.