Career Center

General Summary

The Care Manager coordinates the care and service of selected patient populations across the continuum. He/ she works collaboratively with physicians and other members of the health care team to achieve the highest quality clinical outcomes with the most cost effective use of available resources. The Care Manager assumes responsibility for an interdisciplinary process which assesses, plans, implements, monitors and measures the effectiveness of interventions to meet patients' treatment and transitional needs.

CARE MANAGER COLLABORATION: Collaborates with physicians and other health care professionals to promote appropriate use of medical center resources. Provides physicians and ancillary departments with data on treatment outcomes and avoidable delays in order to promote highest quality care. Communicates and negotiates with outside agencies, including insurance carriers, in order to obtain needed services for patients and accurate reimbursement for medical center. Works with interdisciplinary team to coordinate needed services to ensure efficient continuity of care.

DOCUMENTATION AND MEASUREMENT: Uses severity of illness/ intensity of services indexes to determine appropriateness of admissions, transfer and continued stays. Documents actions in medical record according to departmental guidelines and oversees process of exchange of information with other facilities/ agencies adhering to legal mandates regarding confidentiality. Measures effectiveness of interventions through direct communication with patients and caregivers and data collection of defined indicates (e.g. overall length of stay, readmission rates, feedback from referral services, etc.).

PATIENT CARE: Plans for care needs with active involvement of patient, significant others and hospital staff involved in treatment process. Oversees implementation of transition plans with support from internal and external agents. Monitors patients' progress and adequacy of planning process through regular communications with patients and service providers. Provides information and support to patients and families, helping them access needed resources within the medical center and community.

PROBLEM SOLVING: Identifies problems or gaps in community resources that impact outcome and takes leadership role in efforts to effect changes. Takes a leadership role in identifying opportunities to reduce risks, both financial and clinical, through analysis of resource consumption outcomes.