CARE MANAGER - Yale New Haven Health System (new haven, connecticut) in New Haven, Connecticut For Sale
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These valuesA?integrity, patient:centered, respect, accountability, and compassionA?must guide what we do, as individuals and professionals, every day.The Care Manager is responsible and accountable for ensuring high value patient care that is coordinated, efficient and aligned with institutional clinical and financial objectives. In collaboration with the healthcare team, the Care Manager utilizes evidence based practice to ensure that specific patient outcomes are reliably achieved and that resources are appropriately used within designated fiscal time frames. With our members of the health care team, the Care Manager participates in the ongoing evaluation of practice patterns and supports efforts to improve patient care and enhance efficiency of operations. The Care Manager interacts with others in the identification of trends and barriers to all aspects of care. Through this interaction, the Care Manager identifies and works toward a resolution as a part of the multidisciplinary team.EEO/AA/Disability/Veteran1. 1. As part of the interdisciplinary health care team, coordinates and ensures the implementation of the plan of care, utilizing the principles of case management.1.1. Establishes a system for coordinating the care of a patient throughout the continuum of care, linking the inpatient care with outpatient care, services and case management.1.2. Reviews the healthcare information with healthcare team. Reviews the admitting diagnosis/problems with the healthcare team. Monitors the course of patients and the adherence of this course to clinical pathways or the patients treatment plan.1.3. Reviews the plan with physician, primary nurse and other members of the team as appropriate and insures that communication is taking place with patient and family.1.4. Demonstrates the knowledge and skills necessary to provide care needs appropriate to the age of the patients served on his or her assigned patient populations.1.5. Facilitates communication within the health care team and with the primary care physician and other disciplines to coordinate patients progress through clinical pathways or the patients treatment plan.1.6. Ensures that the sequencing and scheduling of interventions, treatment, and procedures are in accordance with the clinical pathways or the patients treatment plan.2. 2. Optimizes the efficiency of hospital systems which impact quality and/or length of stay 2.1. Identifies and monitors compliance with documenting variances from established parameters in the clinical pathway or treatment plan.2.2. Collaborates with other departments to accelerate scheduling and to facilitate access to tests and consultations.2.3. Identifies trends, themes, and consistent barriers and work collaboratively with healthcare team2.4. Intervenes when necessary to correct delays and to address any barriers for patients.3. 3. Utilizes information obtained from various resources available to:3.1. Ensure that each patient meets the clinical needs for admission, treatment, and discharge and initiates appropriate follow through with the health care team.3.2. Collaborate with health care team to initiate referrals to the appropriate service and/or provider, ensuring that adequate insurance coverage and reimbursement are obtained.3.3. Identify patients who are likely to have unmet insurance and resource needs and communicate with healthcare team members and other appropriate departments.3.4. Communicate as needed with third party payors regarding the patients progress with the treatment plan.3.5. Collaborates with case manager and representatives from third party payor regarding services available when barriers are identified.3.6. Review admissions daily to ensure appropriateness.4. 4. Assist clinicians in documenting the appropriateness of admissions and continued stays4.1. Responsible for Medicare no
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