SSH-CASE MANAGER-RN

This position will travel to different locations in Mid-Michigan.

General Purpose of Job:

To manage cases in collaboration with the health care team by evaluating appropriateness for admission to Sparrow Specialty Hospital, assessing, planning, coordinating, monitoring and evaluating the options and services required to meet an individual's psychosocial, resource deficit and continuing health care needs in the most financially responsible manner while in Sparrow Specialty Hospital. Plans, organizes and supervises Case Management services.

Essential Duties:

This job description is intended to cover the minimum essential duties assigned on a regular basis. Associates may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

• Assists referral hospitals in identifying potential Sparrow Specialty Hospital admissions.
• Educates and Markets referral hospitals regarding Sparrow Specialty Hospital programs and services.
• Clinically screens, evaluates and recommends patients in referral hospitals for admission to Sparrow Specialty Hospital.
• Assists in collection of financial information required to assess financial appropriateness of Sparrow Specialty Hospital patient candidates.
• Performs admitting function and may perform discharge function.
• Performs admission and continued stay review, applies SI/IS/DS criteria, determines action on cases, communicates with physicians and discharge planning case managers as to appropriate length of stay, documents the rationale for case determinations, determines the next review date.
• Refers appropriate cases and communicates effectively with the Utilization Review Committee's physician reviewers.
• Participates in the Utilization Review Committee.
• Communicates effectively with third party payers and reviewers and documents reviewers' decision, length of stay and next review date.
• Communicates billing/patient status information to other departments within the Health System.
• Participates in health system meetings and initiatives that aid in patient throughput (i.e. - bed meeting, critical care rounds, etc.)
• Provides clear, concise, timely written documentation on the patient's medical record and on departmental records.
• Communicates with patients, families, and members of the health care team and others in a professional, diplomatic and empathetic manner.
• Participates in activities which support and advance the department and the SSH mission, vision and goals to improve outcomes and operations.
• Provides or arranges education for patients, families, physicians and other members of the health care team, to enhance patient care or improve department outcomes and operations.
• Utilizes Performance Evaluation System to identify ongoing goals, establish action plans and documents steps taken to improve job performance.
• Participates in the planning, implementation and evaluation of quality improvement activities within department, health system and/or community.
• May travel as necessary.
• Participates in the accreditation process.
• Compliance with Infection Control Standards, including Standard/Universal Precautions, Hand Hygiene and Personal Protective Equipment (PPE).
• Accountability for maintaining a Healthy Work Environment by adhering to the "Commitment to my Co-workers" principles.
• Compliance with mandatory job related requirements (i.e. staff meetings, in-services, annual competencies and TB testing).
• Maintains knowledge of current trends in area of expertise and provides evidence of current competencies.
• Performs other duties as assigned.