Case Manager - McLaren Careers
McLaren Health Care
Coordinates, negotiates, procures and manages the care of an assigned patient population. The objective is to facilitate quality clinical outcomes, promote patient satisfaction, assist in managing length of stay and oversee the discharge planning process.
**Essential Functions and Responsibilities:**
1. Conduct reviews for medical necessity on admission and for continued stay to ensure patients meet criteria for hospitalization.
2. Obtains authorizations for hospital admission from payers when required.
3. Conducts a comprehensive assessment of the patient’s physical health status, functional capability, mental status, psychological needs, personal and community support, financial resources, and environmental conditions to develop and coordinate interventions needed to reduce barriers and formulate discharge plans.
4. Establishes course of action by exploring options; setting goals with client.
5. Obtains assistance for the patient by referring him/her to community resources.
6. Documents in the medical record: assessment, goals, plans, interventions, barriers and reassessments as necessary to facilitate discharge.
7. Maintains effective operations by following policies and procedures; participating in quality reviews; reporting needed changes.
8. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.
9. Complies with federal, state and local legal and certification requirements by studying existing and new legislation; anticipating future legislation; enforcing adherence to requirements; advising management on needed actions.
10. Performs other related duties as required and directed.
REQUIRED
Bachelor's degree in social work
State licensure as a Social Worker
PREFERRED
Masters Degree in Social Work
Utilization management (review) and discharge planning experience
Certification in Case Management, either CCM or ACM (Commission for Case Management or American Case Management Association)
Basic Life Support (BLS) certification as a Healthcare Provider or equivalent through the Military Training network (MTN)
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