General Summary of Position
MedStar Health is looking for an Inpatient Case Manager to join our team at MedStar Southern Maryland Hospital!
As an Inpatient Case Manager, you will timely and efficiently identify patients who need discharge planning, assessment of psychosocial impact of illness, provision of direct services, coordination of the discharge plan, liaison with community resources, evaluation of effectiveness of the planning process, and identification of gaps in services. Outcomes attained collaboratively with patients, family members, physicians, healthcare providers and others.
Join one of the largest healthcare systems in the Baltimore-Washington metro region, also recognized as one of the "Healthiest Maryland Businesses". Apply today and learn how MedStar Health can be your next great career move!
Interview/counsel patients, families, significant others to assess psychosocial functioning and discharge planning needs specific to that patient. Develop and implement Social Work/Discharge Planning treatment plans to assure timely provision of services based on age and diagnosis of patients served and associate area of specialization.
Participate in developing and implementing effective, efficient case finding with other health care team members to assure access to social work services. Develop and coordinate plans with patients and families with medical and other hospital staff or referral and/or transfer to other appropriate levels of and/or community agencies to ensure appropriate use of hospital resources. Serve as a patient advocate in assuring a collaborative approach to patient care management. Develop and maintain effective working relationships with colleagues, medical staff, other hospital staff and a variety of community health and welfare agencies/facilities. Maintain up to date clinical documentation on patient medical records according to departmental policies and standards.
Make appropriate referrals to Pastoral Care. Make appropriate referrals to community action groups, support groups etcetera. Perform utilization review, regardless of payor source, in accordance with the Utilization Management Plan and State of Maryland Regulations: Perform and document admission and continued stay review, using nationally accepted InterQual guidelines to establish medical necessity of hospital stay. Readily distinguishes between acute, intermediate, and skilled levels of care.
Contact health insurance companies at specified intervals to assure reimbursement for continued stay. Refer concurrent/admission utilization problems/issues to the Physician Advisor or Medical Director. Advise the physician of appropriate commercial insurer requirements, such as Medical Assistance second opinion requirement. Maintain up to date clinical records according to departmental policies and professional standards; prepares monthly statistical reports.
Maintain all social service policies and procedures in accordance with current professional standards. Arrange DME (Durable Medical Equipment), ambulance service, home care, and respiratory care as medically indicated. Assists and empowers clients to participate in their treatment plan; engages client in therapeutic relationship; educates client regarding mental health services and their benefits; assists members to use services appropriately; makes appropriate recommendations and referrals for patients to obtain information, support, services, and assistance they may need from MedStar Southern Maryland Hospital or community resources. Recommends patients for inpatient or outpatient mental health care and refers to appropriate setting.
This position has a hiring range of $60,632 - $107,494
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