Telephonic Case Manager

PURPOSE AND SCOPE:

Promotes quality patient care, ongoing patient support and case management for Fresenius Medical Care (FMCNA) renal patient population (internal and external) by providing guidance, support, care coordination, education and other case management functions as defined by the pertinent program.

Manages the implementation of the pertinent program as assigned while acting as the subject matter expert and resource for patients, dialysis staff, physicians and other healthcare professionals.

Services are generally provided telephonically but there may be programs where on-site visits to clinics, medical office, hospital are required.

PRINCIPAL DUTIES AND RESPONSIBILITIES:



* Utilizes nursing knowledge and judgement, data analysis, time management skills, review of medical information, collaboration with clinical and non-clinical members of the healthcare team, and knowledge of clinical processes to develop and facilitate coordination of care for value-based program patients via telephonic support.


* Leads the assessment of patient conditions, in conjunction with clinic staff, such as the discovery of unreported medical and social conditions, or changes at home that may lead to adverse outcomes and ensures these concerns are referred to the appropriate sources for attention.

Utilizes good documentation practices to accurately document interactions with members, members' health records, caregivers, and other stakeholders.

Maintains and updates the appropriate software/tracking logs of patients in the program to manage and record required information and data.

Generates and analyzes reports as needed for management, identifying trends, anomalies, and areas of concern.


* Utilizes clinical judgment, independent analysis, critical thinking skills, time management skills and detailed knowledge of case management program.


* Adheres to company, department, program policies and clinical guidelines to identify, review, assess and allocate patients for program participation according to their identified needs.


* Acts as a representative of the Nursing and Clinical Services department in collaborating with the FMCNA Medical Office and with the clinical staff, physicians, and other members of the patient's healthcare team, to develop an individualized and comprehensive plan of care according to the applicable program specifications.


* Leads and ensures the coordination and integration of services as planned in the pertinent program while revising the plan as needed to provide high quality continuity of services and cost-effective service delivery.


* Utilizes motivational interviewing techniques to influence members to engage in their own care.


* Builds collaborative, productive relationships with teammates, members, and other stakeholders.


* Participates in process improvement activities.


* Self-manages worktime to ensure completion of assigned work during scheduled shifts.


* Adheres to sch...