Case Manager

Stamford, CT, United States

Job Description

The Case Manager (CM) is a health care professional who is responsible for overseeing the implementation of patients' health care services.

Facilitates the care of patients in the ambulatory care setting to ensure quality outcomes and appropriate utilization of health care resources. The CM works in collaboration with a multi disciplinary team in the planning, implementation and evaluation of medical and nursing care. Is a key member of a multi-disciplinary team whose primary objective is to care coordination close gaps in care. Performs all job duties and responsibilities in a courteous and customer-focused manner.

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Responsibilities

1.Works in conjunction with assigned social worker/case manager coordinating complex patient care throughout the continuum of care among the interdisciplinary team for identified population with a focus on complex LOS issues, readmission and high utilizers of the ED.

2.Provides ongoing assessment and case management of identified patient population to ensure an accurate evaluation of patient needs, appropriate level of care, proper resource utilization, and quality of care and risk management in post-acute setting. Develops goals for patient outcomes based on assessment within identified time and documents in clinical records as indicated with the assigned Case Manager.

3.Monitors and evaluate the plan of care on an ongoing basis and revises goals as needed.

4.Assures compliance with utilization requirements relative to all payer types and contract requirements in post-acute settings in identified population. Assures compliance with federal, state and local requirements e.g. ADA, Workman's Compensation, EMTALA.

5.In coordination with social work/case management maintains ongoing communication regarding patient care with physicians, referral sources, caregivers, patients, etc. to facilitate, coordinate, and transition of care. Communication is effective and clear while following identified population in post-acute setting.

6.Independently initiates assessments of situations, identifies and explores alternatives and chooses appropriate course of action in areas within scope of practice.

7.Acts as an advocate for individual's health care needs. Identifies barriers and advocates for patient to access to care. Identifies system problems within the acute care system as well as the community which are barriers to timely care.

8.Establishes communication system with payers to determine benefit eligibility. Maintains knowledge of payer requirements.

9.Responsible for maintaining a professional relationship with referral sources and community resources and participating in local professional organizations and activities.

10.May conduct visits in the field, home, skilled nursing facility, doctor's office, etc. when needed to assess and/or evaluate patient's needs or environment of care.

11.Provides patients and families support and information about their current disability.

12.Provides education and support to hospital staff regarding community resources, managed care issues, or payment/ payer issues.

13.Responsible for maintaining a professional relationship with referral sources and community resources, and participating in local professional organizations and activities.

14.Demonstrates an ability to be flexible, organized and functional under stressful situations. Utilizes critical thinking skills and sound judgment in priority setting and delegation.

15.Practices autonomously, consistent with evidenced-based standards. Pursues personal and professional growth and development.

16.Performs other related duties as assigned or requested in order to maintain a high level of service.

Qualifications

Bachelors prepared Registered Nurse licensed in the state of Connecticut is required. Strong clinical experience in an acute care setting with additional experience in home care, long term care and case management is preferred. Professional certification in case management or clinical specialty is highly desirable.

Strong organizational and communication skills are essential.

Completes required department and organization training and education in a timely manner.

Demonstrates professional work behavior by following Service Standards and Success factors.

Complies with departmental organizational policies and procedures and adheres to external agency requirements.

About Us

About Stamford Health

Stamford Health is a non-profit independent health care system with more than 3,800 employees committed to caring for the community through a wide range of high-quality health and wellness services. Patients and their families receive expert, compassionate care through the system's 305-bed Stamford Hospital; Stamford Health Medical Group, with more than 40 offices in lower Fairfield County offering primary and specialty care; a growing number of ambulatory locations across the region; and support through the Stamford Hospital Foundation.

Stamford Health is known for its expert, person-centered care through its many recognitions and partnerships. U.S. News & World Report has recognized Stamford Hospital as a High-Performing Hospital. The Centers for Medicare and Medicaid Services (CMS) rated Stamford Hospital as a five-star hospital for Overall Quality and The Leapfrog Group awarded Stamford Hospital an "A" for patient safety. The American Nurses Credentialing Center has granted Stamford Hospital Magnet Status, which recognizes superior patient care with the highest level of safety, quality, and patient satisfaction. Stamford Health is Planetree Gold-Certified for Excellence in Person-Centered Care and is a Certified™ Great Place to Work.

Stamford Health is a major teaching affiliate of the Columbia University Vagelos College of Physicians and Surgeons and has recently expanded its relationship with Columbia to offer treatment and expertise from Columbia University Irving Medical Center's nationally recognized heart surgeons. Stamford Health and Hospital for Special Surgery (HSS) have created a premier center for specialty orthopedic care right in Stamford, Connecticut. Additionally, in 2020 Stamford Health's Carl & Dorothy Bennett Cancer Center entered into an expanded collaboration with Dana-Farber Brigham Cancer Center.

Dedicated to being the community's most trusted health care partner, Stamford Health puts patients first to build long-lasting relationships. For more information, visit StamfordHealth.org. Like us on Facebook and follow us on Twitter, Instagram, YouTube, and LinkedIn.

About the Team

Why work for Stamford Health?

Stamford Health offers an extremely competitive salary with generous shift differentials where appropriate.

Our Total Rewards Program is ranked as one of the highest satisfiers based on our employee engagement surveys.

With over 100 transfers and promotions each year for the past 5 years, Stamford Health is a place for you to grow and develop your career. Many departments from Nursing to Information Systems and Rehabilitation have Career Ladder programs that foster career development.

Whether employees choose to live in the greater Stamford, CT area or commute from New York or Fairfield, we offer free convenient parking and free transportation from the Stamford train stations.

Our collaborative with Hospital for Special Surgery, and the Dana Farber Brigham and Women's Cancer Care Collaborative, connect us directly with world class expertise, research, resources and technology to put us at the forefront of patient care.

We have a robust Professional Development and Organization Development program that provides both clinical and non-clinical staff with the opportunity to develop and grow professionally.

For organizational leaders, we offer a comprehensive New Manager Orientation four times per year. Our program designed specifically for Stamford Health will help prepare today's and tomorrow's leaders for success with an innovative curriculum based on best practices. It will also enhance the skills of our leaders that bring their fresh leadership perspective from other organizations.