Medix Staffing Solutions
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LVN or RN Case Manager
at Medix Staffing Solutions
- Care Management is a collaborative practice model including patients, nurses, social workers, physicians other practitioners, caregivers and the community.
- The care management process encompasses excellent communication, both verbal and written and facilitates care along a continuum through effect resource coordination.
- The goal of the Care Manager is to advocate for and assist the patient in the achievement of optimal health, access to care and appropriately utilizing resources.
- The LVN Care Manager utilizes the following processes to meet the patient's individual health care needs: collects data, assists in planning, implementation, coordination, monitoring and evaluation of the plan of care.
- Data Collection: collecting in depth information about a persons' and functional status to identify individual needs to develop a comprehensive plan of care.
- Care Manager will identify present and possible future needs of the patient and family.
- Data will include age specific physical, psychological, environmental, financial and health status expectations
- Planning: assist with identifying specific objectives, goals and actions identified in the collection of data.
- Care Manager will act as a patient advocate and collaborate with the physician, patient and family, members of the healthcare team to formulate a shared plan of care.
- Goals and time frame for goals appropriate to the patient will be set.
- Implementation: executes specific interventions that will assist in accomplishing the goals and timeframes of the shared plan of care.
- Works effectively with the healthcare team to determine necessary steps to achieve plan of care
- Problem solving techniques will be applied to the implementation process.
- Care Manager will utilize knowledge of alternative funding sources, benefit plans, and contractual information to promote appropriate quality, cost effective care for members throughout the healthcare continuum.
Coordination: organizes, coordinates, provides and modifies or obtains appropriate authorizations to accomplish the patients goals and initiates and communicates with the patient and family, physicians, healthcare team members and community.
- Facilitates continuity of care throughout all access points.
- Monitoring: obtains sufficient information from all relevant resources in order to determine the effectiveness of the plan of care, and/or services provided.
- Manages a caseload of high risk, complex needs and/or catastrophic patient
- Care Manager at appropriate and repeated intervals, evaluates the patients' progress.
- If progress is static or regressive, Care Manager will determine the reason and encourage appropriate interventions to obtain optimal outcomes, including communication with healthcare team.
- Care Manager will modify plan of care as necessary in coordination with the healthcare team, family members and providers.
- Communication: Care Manager will communicate both verbally and electronically with the patient and healthcare team.
- Appropriately documents the plan of care, patient progress, outcomes, statistical reporting, logs and files abiding to departmental, legal and regulatory requirements.
- Research and assist in the resolution of patient appeals, grievances and complaints by gathering necessary clinical information and responses as appropriate.
- Files appeals and grievances within the appropriate timelines set by regulatory compliance.
- Reports findings (time frame: monthly, quarterly) to (appropriate committee)
- Performs all other duties as assigned