Case Manager Specialist
Company: Legacy Health System
Posted on: September 22, 2022
The Case Manager:
* Coordinates and facilitates interdisciplinary provision of
comprehensive, patient-centered, quality health care throughout the
continuum for patients with acute and chronic health
* Fosters achievement of optimal health care outcomes within
accepted standards of care.
* Serves as an expert resource to the healthcare team regarding the
continuum of care, efficient use of resources, Best Practice
protocols, team-based care, quality indicators and improvements,
and regulatory requirements.
* Ensures a smooth transition of care between multiple health care
environments with planned handoffs.
* Partners with patients and families in identifying health care
issues and barriers to self-care in order to set priorities and
engage in appropriate interventions.
* Demonstrates cultural agility and employs health literacy
guidelines to provide education regarding self-management
* Utilizes rapid quality improvement cycles to continuously
monitor, evaluate, measure, and report progress of interventions
* Paces the case to assure appropriate and fiscally sound care
coordination across the continuum.
Legacy Salmon Creek Medical Center is Southwest Washington's most
modern hospital, offering the latest technology in a setting
designed for comfort and care for the whole family. We feature
innovations in joint replacement, robotic surgery, pelvic health
for women, cancer care, intensive care for newborns, neurosurgery,
medical care for children and more.
Facilitates daily multidisciplinary care coordination meetings to
clarify patient plan of care.
Communicates with patients and their families concerning the
progress of patient recovery goals and ongoing care needs.
Organizes and/or participates in patient care conferences.
Coordinates care and expected outcomes between patients/families
and healthcare team including nurses, social workers, physicians,
therapists, and community agencies and resources.
Develops and maintains a collaborative working relationship with
all team members.
Follows evidence-based best practice.
Serves as the clinical resource manager for patients with complex
Provides consultations for patients who do not follow or have
multiple variances from a pre-established clinical path.
Assesses patient care priorities with patient and staff as part of
the health care team and participates in determining outcomes of
Collaborates with patient, family, and other health care
professionals in the establishment of goals and implementation of
patient plan of care.
Facilitates referrals, multidisciplinary review and planning for
Maintains currency in case management practice and principles
specific to venue.
Ensures transition plan reflects national guidelines and/or
Maintains knowledge of professional standards of practice through
participation in continuing education, community and professional
activities, and committee membership.
Assists patient care team to identify and coordinate appropriate
level of care across the health care continuum.
Focuses on promoting early intervention for complex patients and
communicating a coordinated plan of care to prevent unnecessary
complications and negative patient outcomes.
Communicates with UM RN(s) and with insurance and community case
managers, when appropriate, to discuss benefits and obtain
authorization for alternative level of care.
Assists health care team to incorporate the educational needs of
patients and/or families concerning alterations in health and the
disease process into the plan of care.
Assists with patient and family education as appropriate and
Collaborates with Legacy leadership to identify educational needs
Participates in and/or leads committees and task forces.
Participates in identifying needs and developing programs which
facilitate attainment of organizational goals.
Represents applicable clinical areas in the review and development
of hospital and overall system policies, procedures, protocols,
guidelines, and standards.
Participates in Continuous Quality Improvement (CQI)
Participates in data collection, analysis and reporting of defined
indicators to facilitate comprehensive evaluation of program
Collaborates with Legacy management team and staff in developing
and utilizing quality indicators to monitor and evaluate care and
Participates as an active member in department meetings and group
Sponsors changes to improve department operations and supports
others' suggestions for change.
In setting professional goals, includes attainment of case
Academic degree in nursing (BSN or MSN/MN) required; MSN/MN
This position requires extensive knowledge of disease management to
include diagnostics, treatment and prognosis, community resources
and healthcare reimbursement. Minimum 2 years clinical nursing
experience required. Relevant experience in one or more of the
following healthcare areas preferred:Coordination of community
resourcesCare management of diverse patient populationsAmbulatory
Care Knowledge of levels of care throughout the health care
continuum to include; inpatient, emergency care, rehab, home
health, hospice, long term acute care, SNF, ICF, ALF with an
overall understanding of utilization management and resource
management.Working knowledge of Care Management models across the
Knowledge of six core components of case management:
Healthcare management and delivery
Principles of practice i.e. CMS guidelines, Interqual criteria
Case Management concepts
Excellent organizational skills
Health literate oral and written communication skills for effective
interaction with all members of the patient's health care team
Knowledge of transitional planning to and from all venues
Ability to determine and access appropriate community resources
Ability to engage patient/family in discussion of health care goals
and decisions with attention to cultural and health literacy
Ability to adhere to and implement regulations in an effective
manner. Must serve as a resource to all team members regarding
Keyboard skills and ability to navigate electronic systems
applicable to job functions.
LEGACY'S VALUES IN ACTION:Follows guidelines set forth in Legacy's
Values in Action.
Equal Opportunity Employer/Vet/Disabled
Current applicable state RN licensure. Case management
certification preferred. AHA BLS for Healthcare Providers required
for all employees who perform this job in the state of Oregon.
Keywords: Legacy Health System, Vancouver , Case Manager Specialist, Executive , Vancouver, Washington
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