Wheaton, IL – Clinical Case Manager

SALARY: $27.74
$54,101.00 Annually
DEPARTMENT: Kenneth Moy DuPage Care Center
HOURS: Monday – Friday 8:00 a.m. – 4:30 p.m. with rotating evenings and weekends as scheduled

POSITION SUMMARY:
We are pleased to offer the opportunity to work as a Clinical Case Manager within Kenneth Moy DuPage Care Center. This position will provide professional clinical case management to patients and clients coordinating services, treatment status, discharge plans and communicating benefits and financial information.

RESPONSIBILITIES:
Responsibilities Include:

• Reviews, assesses and documents benefit, medical, social and financial information in an accurate and appropriate manner
• Establishes contacts with family, payer and other internal and external customers
• Develops and coordinates safe, effective, realistic and timely discharge plans in coordination with patient, family and team and prepares discharge papers
• Conducts Minimal Data Set (MDS) interviews and completes assigned sections of MDS 3.0 including assigned Care Area Assessment (CAA)
• Completes initial assessment, social history, and discharge assessment
• Schedules and coordinates care plan meetings
• Maintains and updates discharge calendar for interdisciplinary coordination of services
• Assists new patients/families with the completion of admission paper work
• Develops and maintains current documentation in the medical records regarding status of discharge plans, case management authorizations, utilization review and family issues related to discharge, mood, behavior issues, and progress notes
• Completes designated portion of patient functional profile and other routine statistical reports
• Obtains and documents authorizations for continued stay, procedures and tests ordered as medically necessary, per payer requirements
• Coordinates completion of letters of medical necessity
• Coordinates and facilitates interdisciplinary meetings
• Assists in conveying nursing, medical, psycho-social and or benefit/financial information to discharge referral agencies
• Assists in facilitating a smooth transition to alternate levels of care or discharge destination.
• Monitors length of stay of all cases for evidence of medical necessity
• Acts as patient advocate utilizing internal and /or community resources to meet the patient’s medical, social and/or financial needs to be successful at the discharge destination
• Conducts resident interviews for investigations
• Reviews patient documentation and status for continued progress, goal achievement and justification of current care level against in-house criteria

REQUIREMENTS INCLUDE:
Requirements include the following experience or equivalent combination of training and experience:

• Completion of a Master’s degree in Social Work, Psychology, or a related human service field
• Two (2) years of experience within a skilled nursing facility working with Medicare/Medicaid populations

Post-offer physical is required.
A pre-employment background check is required.