The Certified Case Manager (CCM) serves as a key member of the interdisciplinary team and actively manages and directs resource utilization to achieve the highest quality outcomes during a patient's rehabilitation experience. The CCM coordinates and advocates for the patient during their hospitalization and from admission to post discharge. As an effective communicator, the CCM manages information to effectively oversee health care delivery and facilitate interdisciplinary plan of care decisions. The CCM facilitates timely communication regarding the patient's care, establishes and monitors the discharge plan implementation while identifying and addressing patient's psychosocial and support systems issues. The CCM oversees the effective coordination of services and manages issues in the following main areas: admission and discharge, team conference and interdisciplinary plan of care communication, patient and family education, payor relations and total fiscal management. The CCM performs ongoing utilization review and acts as a liaison to the payor while assuring that cost effective treatment is provided by the team. The CCM assures that regulations regarding patient's rights are fulfilled.
Job code: 100680
License and Certification:
- Must be qualified to independently complete an assessment within the scope of practice of his/her discipline (for example, RN, SW, OT, PT, ST, and Rehabilitation Counseling).
- If licensure is required for his/her discipline within his/her state, individual must hold an active license.
- Current CCM® or ACM certification required.
Education, Training and Years of Experience:
- For Nursing, must possess minimum of an Associate Degree in Nursing, RN licensure with BSN preferred. A diploma is acceptable only in those states whose minimum requirement for licensure or certification is diploma rather than Associate Degree.
- For all other eligible licensed or certified health care professionals, must possess a minimum of a baccalaureate degree and graduate degree is preferred.
- 2 years of rehabilitation experience preferred
Machines, Equipment Used:
- General office equipment such as telephone, copy machine, fax machine, calculator, computer.
- Good visual acuity and ability to communicate.
- Ability to lift, lower, push, pull, and retrieve objects weighing a minimum of 30 pounds. Reasonable assistance may be requested when lifting, pushing, and/or pulling are undertaken which exceeds these minimum requirements.
- Adheres to the company's Standards of Business Conduct.
- Maintains current licensure and/or certifications, if applicable.
Skills and Abilities:
- Ability to speak, read, write, and communicate effectively.
- Ability to coordinate, analyze, observe, make decisions, and meet deadlines in a detail-oriented manner.
- Ability to work independently without supervision.
- Indoor, temperature controlled, smoke-free environment. Occasional outdoor exposure.
- Exposure or potential exposure to blood and body fluids may be required.
- Handicapped accessible.
- May work under stressful circumstances at times.
Proficiency or Productivity Standards:
- Meets established attendance standards.
- Adheres to hospital/department dress code including wearing ID badge.
- May be required to work weekdays and/or weekends, evenings and or night shifts if needed to meet deadlines.
- May be required to work on religious and/or legal holidays on scheduled days/shifts.
- Will be required to work as necessary during disaster situations, i.e., before, during or after a disaster.
- May be required to stay after workday to assist after a disaster situation until relief arrives.
- May be required to perform other duties as assigned by supervisor.