Case Manager

OrthoVirginia, Virginia's largest provider of expert orthopedic and therapy care, is currently seeking full-time, experienced Case Manager to join our team! Along with a collaborative, team-oriented work environment, our outstanding employment package includes: competitive salaries, excellent medical, dental, and vision benefits, paid time off (PTO), a generous 401k plan, profit sharing, short-term and long-term disability insurance, life insurance, and a company-wide wellness program. This position can be located in one of our OrthoVirginia locations in Richmond, Lynchburg or Northern Virginia.

 

Position Summary

The Case Manager will provide optimal quality and continuity of care from the pre-operative setting through a ninety day episode of care, as part of the Bundled Payment Care Initiative. Case Manager will develop care plans that are specific to each patients physical, mental and social needs, based on pre-surgical clinical risk assessments. The care plans will be implemented and modified, as needed throughout the transition of care to ensure the patients well-being and achievement of the desired outcomes. The Case Manager will work collaboratively as part of a multi-disciplinary team to provide patient and family education, communication with health care providers, and facilitation of services within an episode of care under the direction of the physicians.

Primary Functions & Accountabilities

Responsible for case management for all Medicare and commercial bundle orthopaedic patients, Provide optimal quality and continuity of care from the pre-operative setting throughout a ninety day episode of care

1.1. Maintain confidentiality of all patient information per HIPAA and practice guidelines.

1.2. Ability to communicate professionally and effectively with all members of the healthcare team, as well as, in simple and concise language to patients and their families.

 Develop and implement care plans that are specific to each patients physical, mental and social needs, based on pre-surgical clinical risk assessments to ensure the patient's well-being.

2.1. Educate the patient and caregiver of the process and expectation of the healthcare delivery system throughout the course of care, primarily Home Care.

2.2. Gather clinical information from the EMR and conduct telephonic health assessments.

2.3. Document clinical assessments and care plans in case management system.

 Throughout the transition of care, implement and reevaluate patient progress, as needed to ensure the patient's well-being and achievement of the desired outcomes.

3.1. Follow up on patients through telephonic interviews and as needed based on patient status.

3.2. Evaluate plan of care and revise on ongoing basis as determined by patient's health status and communication changes to all other disciplines involved in the patient's care.

3.3. Remain flexible and responsive when changes occur in patient activity and workload.

Works collaboratively as part of a multi-disciplinary team to provide patient and family education, communication with heath care providers and coordinator and facilitation of services within an episode of care.

4.1. Collaborate with multidisciplinary team members in the acute, post-acute and outpatient settings to identify patient needs, such as home health care, DME, physical therapy and community services.

4.2. Communicate with providers and multi-disciplinary care team members to facilitate transition of services throughout the continuum of care.

4.3. Identify gaps or barriers in treatment plans to ensure that discharged patients receive appropriate resources and services and communicate these gaps barriers to director of clinical programs and or physicians at the time of occurrence

Other duties as assigned.

Knowledge/Skills/Abilities:

• Excellent customer service and interpersonal skills
• Excellent communication skills
• Excellent problem solving skills with a flexible and creative approach
• Knowledge and experience in the continuum of care for orthopaedic patients
• Knowledge of basic office equipment, Microsoft Office, and practice management systems
• Ability to multitask in a fast-paced environment
• Ability to work autonomously with minimal supervision
• Ability to maintain confidentiality of patient and employee information

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