CASE MANAGER/ MDS ASSISTANT

Case Manager perform the evaluation and implementation of health care plans for individual residents. This position is concerned with providing effective and efficient medical care while managing the costs of treatment. The Case Manager also acts as a liaison between residents, their families, doctors, and health care providers. LPN or RN will also be on the on-call rotation as needed. Must be willing to work a Med Cart as needed.

RESPONSIBILITIES: 

• Work closely with interdisciplinary care team and technology to identify high-risk, complex resident cases 

• Manage care which includes managed care updates, tracking authorization due dates, ensuring accurate levels being billed, referral management and care planning 

• Accurately document and submit medical records 

• Conduct individualized clinical evaluations of residents, their health needs and concerns 

• Develop personalized plans of care, provide education and issue referrals for case management programs 

• Monitor residents’ progress in meeting established goals and modify care plans accordingly 

• Assess new residents to ensure accurate level of care  

• Develop a cohesive and strong team-oriented relationship with physicians, nurses and other healthcare professionals 

• Evaluate and report on resident health outcomes and work in partnership with interdisciplinary healthcare team to facilitate the best in resident care 

• Educate residents and families regarding plan of care 

• Make clinical decisions for routine resident care 

• Demonstrate knowledge in medical care, such as diagnostic procedures, medication, symptoms, and other treatment-related therapies 

• Review medical records including tests, labs, etc. - communicate findings to IDT/physician 

• Guide, intervene and advocate on behalf of residents, their caregivers and/or families in regards to navigating and comprehending the healthcare system 

• Assist in discharge planning as needed 

• Provide emotional support to residents and families 

• Create an environment for open communication 

• Assist in the Quality Assurance and Performance Improvement (QAPI) process 

• Assist with completion of MDS assessments/ tracking records and other MDS related duties as needed 

• Other Job Duties as assigned