Job Description

General Summary

Under supervision of the Case Management Leadership, will manage and oversee the comprehensive assessment, planning, implementation, monitoring, and overall evaluation of individual patient needs. A Case Manager assists in identifying appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the patient and the reimbursement source. A Case Manager will provide care management and coordination of care for patients across various diseases. A Case Manager will focus on achieving patient wellness and autonomy through advocacy, communication, education, identification of service resources and service facilitation. Overall, the Case Manager will promote direct communication with the patient, and appropriate service personnel, in order to optimize outcomes.

Principal Responsibilities and Tasks The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

• Demonstrated knowledge and skills to provide care appropriate to the age of patients served. Demonstrates knowledge of the principles of growth and development over the life span and possesses the ability to assess data reflective of the patient’s requirements relative of his or her age-specific needs
• Knowledge of medical records and the ability to interpret contents and relay information to payer and others as needed is required
• Ability to identify problems, develop course of action and follow through to resolution is required
• Ability to communicate effectively and positively, both written and verbally, with staff, physicians, other hospital personnel, patients and the general public required
• Ability to ensure the confidentiality and rights of patients and the confidentiality of hospital and departmental documents required.
• Duties include:
  • Assessing, planning, implementing and evaluating patient care and education
  • Coordinates patient discharge

Qualifications

Education and Experience

• Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required.
• Must possess five years clinical experience in a healthcare setting.

Knowledge, Skills and Abilities

• Knowledge and experience with managing and overseeing the comprehensive assessment, planning, implementation and overall evaluation of individual patient needs
• Proficient analytical, organization, and problem-solving skills to identify opportunities, to implement efficient work processes as it relates to case management
• Proficient documentation skills to maintain client records
• Ability to work effectively in a stressful work environment and handle confidential issues with integrity and discretion
• Critical thinking skills to analyze and solve problems
• Strong problem management strategies and issue resolution skills
• Excellent interpersonal, verbal, and written communication skills
• Strong organization skills, detail oriented, and knowledgeable
• Ability to work independently and effectively in a fast pace environment.
• Ability to work productively in a stressful environment and effectively handle multiple projects and changing priorities.
• Ability to effectively present information and respond to questions from families, members, providers, and clients, as well as the ability to relate effectively to upper management
• Ability to work independently, handle multiple assignments, establish priorities, and demonstrate high level time management skills
• Understands benefit/payer systems and reimbursement structures for patients.
• Strong clinical knowledge of broad range of medical practice settings and healthcare delivery systems
• Thorough and solid knowledge of health care and managed care delivery systems. This includes standards of medical practice, insurance benefits structure, and the utilization and case management process.
• Knowledge of state and federal laws and resources

Additional Information

All your information will be kept confidential according to EEO guidelines.

Compensation

• Pay Range: $41.14-$50.75
• Other Compensation (if applicable):
• Review the 2024-2025 UMMS Benefits Guide