DescriptionESSENTIAL DUTIES AND RESPONSIBILITIESCoordinate the integration of social services/case management functions into the patient care, discharge, and home planning processes with other hospital departments, external service organizations, agencies and healthcare facilities.Conduct concurrent medical record review using specific indicators and criteria as approved by medical staff, JCAHO, CMS, and other state agencies. Acts as patient advocate: investigates and reports adverse occurrences, and performs staff education related to resource utilization, discharge planning and psychosocial aspects of healthcare delivery.Promote effective and efficient utilization of clinical resources.Mobilizes resources and interviews, as needed, to achieve expected goal to assist in achieving desired clinical outcomes within the desired timeframe.Ensure that patient tests are appropriate and necessary and are carried out within the established timeframe and that results are promptly available.Conducts review for appropriate utilization of services from admission through discharge. Evaluate patient satisfaction and quality of care provided.Assesses patient care required throughout continuum of care for diagnosis, procedures and DRG's.Introduces self to patient and family and explains clinical case manager role and process for patient and family to contact clinical case manager.Communicates with physicians at regular intervals throughout hospitalization and develops an effective working relationship. Assist physicians to maintain appropriate cost, case, and desired patient outcomes.9. Complete expanded assessment of patients and family needs at time of admission. Complete psychosocial assessment.Assess patient's progress through expected hospital course.Refers cases where patients and/or family would benefit from counseling required to complete complex discharge plan to socialServe as a patient advocate. Enhances a collaborative relationship to maximize the patient's and family's ability to make informed decisions.Facilitates interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified post-hospital needs.Collaborate with clinical staff in the development and execution of the plan of care, and achievement of goals.Directs and participates in the development and implementation of patient care policies and protocols in order to provide advice and guidance in handling special cases or patient needs.Coordinates the provision of social services to patients, families, and significant others to enable them to deal with the impact ofIllness on individual family functioning and to achieve maximum benefits from healthcare services.RequirementsEXPERIENCE: Minimum of two (2) years of utilization review/case management experience or social work experience. Minimum of one (1) year experience in discharge planning from a hospital is preferred.EDUCATION: Associate degree in healthcare related field preferred. Bachelor's degree is preferred. Licensed professional nurse may be considered. Bachelors or Masters degree in related healthcare field (such as respiratory therapy or social work) may be considered.REQUIRED KNOWLEDGE/ABILITIES/SKILLS: Currently possesses and/or accepts personal responsibility for increasing job knowledge and developing new skills/abilities that contribute to increased effectiveness, proficiency, and service. Displays sound knowledge of Hospital policies and procedures. Understands needs and requirements of the job. Demonstrates a strong functional knowledge of industry principles practices and responsibilities. Keeps informed of new and emerging trends that are critical to position.REQUIRED LICENSES: Maintain current professional licensure in nursing or professional field of certification. REQUIRED CERTIFICATIONS: Appropriate certification in case management preferred (e.g., Commission for Case management Certification (CCMC); Association of Rehabilitation Nurses (ARN)).ADDITIONAL REQUIREMENTS:PHYSICAL REQUIREMENTS (ADA CRITERIA)The requirements of the job description should denote physical demands for ADA Compliance that would affect the ability to perform the job. Specify Physical Demands that may affect job performance in the requirements section of the job description. Note: Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position. Below, check the activity and list the amount of time required PHYSICAL ACTIVITYStandWalkSitUse hands to finger, handle, or feelReach with hands and armsClimb or balanceStoop, kneel, crouch, or crawlTalk or hearTaste or smellPHYSICAL REQUIREMENTSSedentary Work: Up to 10 poundsLight Work: Up to 25 poundsMedium Work: Up to 50 poundsHeavy Work: Up to 100 poundsVery Heavy Work: Excess of 100 pounds