Your Job Purpose:
Through effective relationships, the Community Based Case Manager (CBCM) helps patients/family recognize patterns of exacerbation of chronic conditions/illnesses and resource use. Helps the patient define goals for health management and quality of life. The CBCM can serve as a bridging tool when patient is no longer eligible for home health, through helping patient/family identify and coordinate other resources. Assumes responsibility for case managed patients through 24-hour/day availability. Prepares regular reports on the effectiveness of the program.
Your Job Duties:
· Assists patient/family in accessing available community services, support, and resources to specifically address identified needs
· Performs and documents ongoing assessment of patient's health status and the availability and use of resources to meet needs; Identifies patterns of exacerbation and helps patient identify and implement actions which decrease "crisis" events; Develops plan of care for case managed patients;
· Monitors and tracks outcomes and resource use for case managed patients; Coordinates the timely review of clinical findings
· Provides monthly updates including evaluation of current, past, and potential patients
· Develops systematic, objective process for identifying potential patients and ongoing need for the program with current patients; is knowledgeable about the development, implementation, and use of clinical improvement initiatives.
· Assists in coordinating preadmission, admission, discharge, and aftercare processes; Serves as a resource in evaluating patient/family environment
· Maintains current knowledge of federal, state, hospital, and JCAHO guidelines relating to medical and utilization management and quality improvement.
· Participates in Methodist Health System's Organizational Effectiveness, Service Management, and Recognition Programs and related activities.
· Provides education to the patient/family on relevant issues regarding their physical condition and disease processes, lifestyle changes, use of resources, nursing interventions;
Your Job Requirements:
· Bachelor's Degree in Nursing required, Master of Science in Nursing preferred
· Board of Nurse Examiner (Texas) license
· Master's degree in Social Work required
· License from respective agency for non-nurse professional
· 5 years of health care experience required.
· 10 years of health care experience preferred