Case Management Coordinator, LVN/LPN II-Sunset Medical Center-Full Time

Provides case management services to a limited caseload of low-risk patients. Coordinates with patients and their caregivers to evaluate needs, goals, and current services. Determines initial eligibility, benefits, and education for all admissions, assessing medical necessity and required level of care to inform physicians. Enters authorization data. Partners in the development of a client-focused case management plan in collaboration with healthcare team, patient, and caregivers that is consistent with regulatory, accreditation, and regional guidelines. Supports patients with gaining access to care based on their needs, making referrals as appropriate. Coordinates resources and services to assure continuity and quality of care. Attends case management rounds with clinician and supports the review of authorizations and diagnoses as needed. Assesses patient progress toward treatment milestones and care plan goals. Assists with identifying barriers to achieving goals and ensures that they are discussed with the patient and care team thoroughly. Assists with verifying that all services remain consistent with established guidelines and standards. Documents the patients case in all medical files. Reviews benefits/services available to patients, caregivers, and other members of the community and assists with problem solving identified concerns. Identifies patients ready for disposition planning activities. Develops and communicates a comprehensive disposition plan in collaboration with the patient, caregivers, physician, nurses, social services, and other healthcare providers and agencies. Obtains authorizations as needed for patient services. Attends professional seminars, workshops, and approved educational programs and workshops. Monitors operational team data and key metrics applied to own work. Makes suggestions for change or improvement as needed. Ensures adherence to policies to meet regulatory requirements.