Case Manager Job Description
Case manager
provides a range of coordinated high quality case management services for portfolios under the Safety, Rehabilitation and Compensation Act 1988 (SRC Act) and Comcare Regulatory requirements, including determination of medical and incapacity entitlements, processing of accounts and file management.
Case Manager Duties & Responsibilities
To write an effective case manager job description, begin by listing detailed duties, responsibilities and expectations. We have included case manager job description templates that you can modify and use.
Sample responsibilities for this position include:
Enter information into the case management systems (Canopy and ECIN)
Perform telephonic case management activities
Maintain comprehensive documentation on all members and care coordination activities in case management system
Assists all departments with resolution of related member retention, utilization management, quality management, customer service, and provider relations concerns
Conducts orientation meetings with new participants to explain program rules and regulations
Conducts orientation meetings with new clients to explain program rules and regulations
Patient education and coaching for patients with chronic illness
Assessing behavioral and clinical needs of patients
Interfacing with providers
Creating and implementing case plans
Case Manager Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Case Manager
List any licenses or certifications required by the position: BLS, CCM, CPR, ACM, CBT, PRI, CMCN, ACMTM, CM
Education for Case Manager
Typically a job would require a certain level of education.
Employers hiring for the case manager job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Master's Degree in Graduate, Management, Nursing, Criminal Justice, Education, Writing, Social Work, Psychology, Sociology, Health Care
Skills for Case Manager
Desired skills for case manager include:
Microsoft Office programs
Regulatory requirements and accreditation standards
Case management
Utilization management
Excel
Discharge planning
Basic medical and psychiatric terminology
Regulations
Managed care
Nurse Practice Act
Desired experience for case manager includes:
Directing members to resources
Review all documentation of patient status to determine appropriate direction of care
Interact verbally with providers and patients in accordance with contract guidelines
Overseeing the patient discharge process
Planning discharge for each unique patient
Ensure patients are fully briefed on the discharge process
Case Manager Examples
1
Case Manager Job Description
Job Description Example
Our company is searching for experienced candidates for the position of case manager. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for case manager
- Integration, coordination, and advocacy for patients and families requiring post-hospital services
- Achieving planned care outcomes by planning and arranging services on discharge
- Overseeing a variety of skilled nursing activities involved in assessing, planning, implementing and evaluating nursing and health care provided to the client
- Working with the patient, family, physician, Community Health/Field Nurses and other health care provides to ensure that the client receives the services necessary to promote health
- Coordinating and organizing the resources and services for assigned case load
- Providing linkages to other community resources and services
- Coordinating internal and external resources to meet identified needs
- Monitoring and evaluating effectiveness of care plans and modify them
- Interfacing with Medical Directors and other members of the health care team on the development of the care management treatment plans
- Assisting in problem solving with providers, claims or service issues
Qualifications for case manager
- Coordinating planned and unplanned transitions from members’ usual setting of care to the next setting as defined by individual member needs and communicating the care transition process with the member or responsible party
- Participating with the attending physicians, primary care physicians, social workers, and discharge planners in transitioning patients to the most appropriate level of care
- Establishing plans of care with patients, providers, and family/significant others that identify and continuously reassessing cost-efficient appropriate levels of care
- Providing patient education, monitoring of health needs, and coordination of community resources
- Maintaining a comprehensive working knowledge of community resources and network services for target population
- Conduct client orientation
2
Case Manager Job Description
Job Description Example
Our innovative and growing company is hiring for a case manager. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for case manager
- Collect intake data, perform client needs assessments and make recommendations to the supervisor regarding treatment needs
- Develop and document program plan goals with clients, monitor treatment stipulations, job readiness preparation, community resource referrals, completion of weekly counseling and budget sheets, mandatory savings and rent payments
- Develop and implement a discharge plan for clients
- Schedule, conduct, and document individual counseling sessions that address client personal issues and program performance
- Make recommendations to the supervisor for corrective action as required and monitor on an ongoing basis
- Facilitate and document group meetings that address substance abuse and correctional pre-release issues
- Maintain client files and ensure compliance with Agency policy regarding confidential information
- Complete counseling sheets, progress reports and closing summaries on all assigned clients
- Complete all client-related documentation and make log entries on all shift activities
- Conduct periodic weekend program monitoring to supervise and train weekend staff in all areas of job responsibilities
Qualifications for case manager
- Assist the supervisor in monitoring and training staff and new personnel
- Using discretion and judgment, implement Agency disciplinary procedures as needed and complete all related paperwork
- Recommend program terminations, directly coordinate returns to custody and handle emergency situations in accordance with policy
- Provide services and counseling to clients participating in Aftercare program
- Perform functions of human service workers such as client supervision, custody, searches, facility rounds, counts, and urine surveillance as needed
- Maintain a working knowledge of and abide by the Agency’s programs, policies, and procedures
3
Case Manager Job Description
Job Description Example
Our growing company is hiring for a case manager. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for case manager
- Develop and monitor wellness plans on behalf of clients with untreated or unstable medical and/or mental health conditions adversely impacting employability
- Implement and monitor client employment plans developed by vocational evaluators, including, but not necessarily limited to Work Experience Program (WEP) assignments, work readiness training, job preparation counseling, external educational vocational training referrals, and unsubsidized job placement
- Regularly meet with assigned clients to monitor progress and compliance with wellness and employment plans, to assist with mitigating barriers to employment
- Schedule and conduct case conferences with other service providers, including vocational evaluators, work readiness and computer instructors, job placement coordinators, job preparation counselors and WEP specialists
- Perform outreach to clients who have failed to comply with mandatory appointments and other program requirements
- Communicate with external medical and mental health providers to ensure client compliance with and timely completion of wellness plans
- Case conference with other service providers on an as needed basis, including vocational evaluators, work readiness and computer instructors, job placement coordinators, job preparation counselors and WEP specialists
- Assign correct levels of care
- Attention to the issues presented by re-admissions and recommending options for safe discharge
- Coordinate all non-elective point of entry admissions
Qualifications for case manager
- Be responsible for identifying community and other resources that are necessary for each individual
- Ensures patient has a primary care physician follow-up
- Collaborate with the Emergency Department (ED) healthcare team to determine the treatment plan
- Oversee the coordination and delivery of comprehensive quality healthcare, in conjunction with the member, PCP and other involved service providers and agencies
- Interact with and obtain relevant clinical information from the member's PCP and all other applicable providers, vendors or agencies
- Identify service utilization trends and potential member needs
4
Case Manager Job Description
Job Description Example
Our company is growing rapidly and is hiring for a case manager. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for case manager
- Conduct monthly integrated clinical assessments telephonically with members on case load to review current status, service provision and satisfaction with services provided
- Manage patient transition to Shire products
- Respond quickly and accurately to all interested parties (agents, wholesalers, management, ) by phone, email or mail regarding inquiries on pending case statuses
- Identify community and other resources that are necessary for each individual and matches specific needs for continued care
- Manage patient transition to home therapy
- Provide ongoing persistence and compliance support by making regular calls to patient/families
- Manage patient transition to Firazyr
- Responsible for functioning as the liaison among all parties involved with the patient both within the hospital and in the community as it relates to the development and implementation of a safe and appropriate discharge plan
- Assures responsiveness to payer systems by maintaining ongoing communication and serving as the primary contact for all external payer sources, in turn generating revenue, enhancing reimbursement, minimizing financial risk and assuring payment for the hospital
- Identifies and fulfills the requirements and needs of payer and referral sources, overseeing negotiations of continued stay rationale, length of stays, and appeals process
Qualifications for case manager
- Relevant diploma qualification will be an advantage
- Initiates activities to develop positive business relationships with payers and referral sources in order to promote repeat business and represent the hospital as a quality institution
- BSN in Nursing (or Bachelor’s Degree in related field) required
- BA degree in related field preferred
- Two (2) years directly related job experience
- Collects participant fees on an on-going basis when required
5
Case Manager Job Description
Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of case manager. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for case manager
- Provides assistance to the inmates or detainees in obtaining needed services
- Provides assistance to the detainees/residents in obtaining needed services
- May perform the duties of a Monitor including resident intakes, check-ins, breath analysis and drug screens, to provide backup when necessary
- Prepares written personalized programs for each resident to establish measurable criteria of expected behavior and accomplishments and a time frame for achieving specified goals
- Assists residents to establish personal budget, locate suitable housing, enroll in educational and vocational programs and participate in family and community activities, as appropriate, to ensure that they are working towards financial independence
- May orient residents upon arrival at facility to provide smooth assimilation into program including having them complete paperwork, take facility tours, or introduce to other residents
- Make entries into confidential resident files to provide the structure for case analysis and program planning and to provide documentation of program participation
- Verifies residents' jobs to ensure residents' employment is suitable under established program plan
- Maintains confidentiality obtained through job duties regarding employees, vendors, residents, and outside agencies so that sensitive information is only given on a "need to know" basis
- Monitors client compliance with alcohol and drug counseling when required
Qualifications for case manager
- Nurse Licensure Compact, allowing for licensure in 24+ states
- One year of experience in the social services or criminal justice field
- Experience providing direct services to individuals with mental disabilities
- Experience in Administrative and/or Customer Service in a Financial Services environment
- A basic understanding of Life Insurance, key terms and how it works
- A superior customer service ethic and ability to relate effectively at different levels