Case Manager, Sr. jobs in Parkersburg, WV

Case Manager, Sr. coordinates the overall interdisciplinary plan of care for patients, from admission to discharge. Monitors care and acts as a liaison between patient/family, healthcare personnel, and insurers. Being a Case Manager, Sr. evaluates the needs of the patient, the resources available, and recommends and facilitates the plan for the best outcome. Develops a discharge plan that provides the best available resources to meet ongoing patient needs and that encourages compliance with medical advice. Additionally, Case Manager, Sr. identifies patient care issues and suggests revisions to or new clinical pathways to improve quality of care. May also be responsible for conducting utilization reviews. Typically requires a bachelor's degree of Nursing. Typically reports to a head of a department/unit. Requires Registered Nurse (RN). The Case Manager, Sr. contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Case Manager, Sr. typically requires 4 to 7 years of related experience. (Copyright 2024 Salary.com)

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Case Manager
  • CCMC Camden Clark Medical Center
  • Camden, WV FULL_TIME
  • Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position. This position comprehensively plans for targeted patient populations. Performs resource management, including denial management, utilization management, access to the appropriate level of care, discharge planning, care facilitation, and referral to other levels of care. Works collaboratively with the multidisciplinary care team to facilitate achievement of desired treatment outcomes. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Current West Virginia licensure as a Registered Professional Nurse or licensure as Registered Professional Nurse in another state with a temporary West Virginia practice permit. EXPERIENCE: 1. Five (5) years clinical experience. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Bachelor’s degree in Nursing (BSN) CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Manages all aspects of transition/discharge planning for assigned patients in a timely manner. 2. Collaborates with all members of the multidisciplinary team to facilitate the transition/discharge process for designated caseload. 3. Monitors the patient’s progress; intervening as necessary and appropriate, to ensure that the plan of care and services provided are patient focused, high quality, efficient, and cost effective. 4. Provides education as needed to staff, physicians, and patients and their families to ensure effective transition planning. 5. Meets directly with the patient and/or family to assess needs and develop an individualized transition/discharge plan in collaboration with the physician team. 6. Communicates with the multidisciplinary team and post-acute providers when applicable, any complex family dynamics that may directly impact patient care and transition/discharge planning. 7. Initiates and facilitates referrals to post-acute services- including but not limited to: Homecare, Durable Medical Equipment, Hospice Care, Long Term Acute Care Facilities, Acute Rehab Facilities, and Skilled Nursing Facilities. 8. Communicates all necessary information regarding transition/discharge plan to the multidisciplinary team, patient and family. 9. Provides timely and comprehensive documentation of interactions with patient and/or families and all transition/discharge planning activities and progress according to departmental policy. 11. Assists patient/families with completion of medical power of attorney, health care surrogate, and advanced directives 12. Collaborates for appropriate resource and financial management which may include but is not limited to: financial assistance coordination/referrals, entitlement program coordination/referrals, or patient benefit coordination 13. Utilizes quality screens in the electronic record to identify potential issues including but not limited to- avoidable delays and readmissions. 14. Completes clinical reviews for patients. 15. Applies approved utilization criteria to ensure medical necessity of patient’s admissions and continued stays, and documents the findings based on department standards, policy and procedure. 16. Screens for appropriate authorization and level of care. 17. Facilitates covered day reimbursement certification for assigned patients and discusses payor criteria and issues on a case by case basis with clinical staff (ie. Peer to Peer) and follows up to resolve problems with payors as needed. 18. Educates hospital staff and physicians to payer regulations and managed care principals to prevent denials. 19. Fosters the integration of staff and/or students into the healthcare team. PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Working closely with others. 2. Working protracted or irregular hours. 3. Working around biohazards. 4. Working around infectious diseases. 5. Working with hands in water. 6. Working with electrical hazards associated with patient care equipment. SKILLS AND ABILITIES: 1. Knowledge of patient’s current medical insurance coverage and limitations and the precertification requirements for Durable Medical Equipment (DME), post-acute placements, infusions, transfers etc 2. Knowledge of relevant scientific principles, established standards of care and/or research findings. 3. Knowledge of procedures and techniques involved in administering routine and special treatments to patients. 4. Knowledge of and appropriate application of the nursing process. Additional Job Description: Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Exempt) Company: CCMC Camden Clark Medical Center Cost Center: 406 CCMC Care Management Address: 800 Garfield Ave Parkersburg West Virginia Thank you for your interest in working for WVUM. Please explore our open opportunities in the list below and apply for any positions in which you would like to be considered. You'll be able to keep track of your progress on our site. The West Virginia University Health System, West Virginia's largest health system with more than 2,700 beds is the state’s largest private employer, is comprised of more than 20 hospitals, including a children's hospital and five institutes, all anchored by a 700-bed academic medical center in Morgantown, West Virginia. Learn more about WVU Medicine here: https://wvumedicine.org/about/
  • 20 Days Ago

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Case Manager
  • Home Base Inc.
  • Saint Marys, WV FULL_TIME
  • Case Manager/Wrap Facilitator Home Base, Inc. St. Mary's, WV 26621 Do you enjoy working with families? Are you interested in Psychology, Social Work or Counseling, or looking to make a career change? ...
  • 21 Days Ago

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CASE MANAGER
  • ResCare Community Living
  • CLARKSBURG, WV FULL_TIME
  • Our Company ResCare Community Living OverviewOur operational team members focus on efficiently meeting the needs of our clients across various lines of business. If your passion is to ensure quality c...
  • 23 Days Ago

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Case Manager
  • Coordinating Council for Independent Living
  • Elkins, WV FULL_TIME
  • Make the work you do matter! Full-time Case Manager is needed for our Elkins, WV office. A Bachelor’s degree in the Human Service Field is required Work is with children and adults within the WV IDD W...
  • Just Posted

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Case Manager
  • Home Base Inc.
  • Elizabeth, WV FULL_TIME
  • Case Manager/Wrap Facilitator Home Base, Inc. Elizabeth, WV 26621 Do you enjoy working with families? Are you interested in Psychology, Social Work or Counseling, or looking to make a career change? A...
  • 3 Days Ago

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Case Manager
  • Harmony Ridge Recovery Center, LLC
  • Walker, WV FULL_TIME
  • The Case Manager is responsible to affect a safe, comfortable and supportive environment for the patients participating in the program. Helping clients with legal, financial and life skills. Teaching ...
  • 3 Days Ago

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0 Case Manager, Sr. jobs found in Parkersburg, WV area

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Intake Advocate (9-month Roster)
  • Internal Revenue Service
  • Parkersburg, WV
  • Summary Click on "Learn more about this agency" button below to view Eligibilities being considered and other IMPORTANT ...
  • 3/28/2024 12:00:00 AM

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Case Management Director II
  • Encompass Health
  • Parkersburg, WV
  • As a member of Senior Leadership, the Director of Case Management (DCM) is responsible for the day to day operations and...
  • 3/27/2024 12:00:00 AM

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Addiction Therapist
  • Clean & Clear Advantage Llc
  • Parkersburg, WV
  • Job Description Job Description **NOW OFFERING COMPANY-PAID DENTAL, VISION, AND LIFE INSURANCE** We are actively seeking...
  • 3/27/2024 12:00:00 AM

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Addiction Therapist
  • Clean & Clear Advantage
  • Parkersburg, WV
  • Job Description Job Description Job description Our passion: Assisting individuals and their families impacted by substa...
  • 3/27/2024 12:00:00 AM

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Licensed Practical Nurse LPN
  • Clean & Clear Advantage Llc
  • Parkersburg, WV
  • Job Description Job Description **$1500 Signing Bonus*Shift Differential*NOW OFFERING COMPANY-PAID DENTAL, VISION, AND L...
  • 3/26/2024 12:00:00 AM

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Nurse Practitioner- PRN/Part Time
  • Matrix Medical Network
  • Ravenswood, WV
  • Overview: Nurse Practitioner PRN/Part Time Home Risk Assessments About Us: Matrix Medical Network offers a broad range o...
  • 3/26/2024 12:00:00 AM

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Marriage and Family Therapist OCA
  • Department of Veterans Affairs
  • Parkersburg, WV
  • Summary * This is an OPEN CONTINUOUS ANNOUNCEMENTfor multiple locations/positions that will remain open until May 14, 20...
  • 3/26/2024 12:00:00 AM

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Senior Specification Writer
  • CDM Smith
  • Parkersburg, WV
  • **37483BR** **Requisition ID:** 37483BR **Business Unit:** TSU **Job Description:** CDM Smith is an engineering and cons...
  • 3/25/2024 12:00:00 AM

Parkersburg is a city in and the county seat of Wood County, West Virginia, United States. Located at the confluence of the Ohio and Little Kanawha rivers, it is the state's third-largest city and the largest city in the Parkersburg-Marietta-Vienna metropolitan area. The population was 31,492 at the 2010 census. Its peak population was 44,797 in 1960. The city is about 14 miles south of Marietta, Ohio. The Baltimore and Ohio Railroad reached Parkersburg in 1857, but lacked a crossing over the Ohio River until after the American Civil War. When the B&O completed the Parkersburg Bridge (CSX) 18...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Case Manager, Sr. jobs
$72,154 to $85,179
Parkersburg, West Virginia area prices
were up 1.2% from a year ago

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