Coordinate with utilization management and discharge planning to provide care to patients.
Evaluate patient’s file, investigate symptoms, administer clinical status and patient history to recommend proper treatment plan after analyzing severity of illness.
Plan and evaluate case by case involving each patient to design care management procedures for individual patient.
Collaborate with internal and external agencies and operate nursing activities in efficient manner.
Coordinate with multi-disciplinary team to plan treatment procedure and contingency plans as per individual requirement.
Identify clinical lapses and issues that violate specified standards and intimate relevant personnel for rectification.
Assist social workers to initiate patients’ rehabilitation.
Monitor and ensure effective implementation of inpatient treatment plan as per guidelines and procedures to facilitate speedy recovery of patients.
Analyze and refer cases to Case Management Medical Director and decide on patient discharge or retention for continued treatment.
Participate in daily case management rounds for units or patients to ensure active participation of staff.
Document and update case management plan as per latest development in treatment and recovery processes.
Organize family meetings with patients, doctors and paramedical staff to communicate effectively patient’s current status.
Assist third party experts to evaluate all clinical reports for further clarification of clinical findings.
Prepare discharge sheets and educate patients and associate family on treatments and sustainably of treatment after discharge.
Manage all communication for NCM or PCP in regard to patient’s clinical status, treatment plan and evaluate treatment requirements.
Develops methods of evaluating facilities and whether promised goals are met through surveys or phone calls to families (service-specific).
Notifies Patient Accounting about actual / potential patient financial concerns.
Follows patients in observation status and establishes disposition within twenty-four hours.
Issues Medicare Important Message and Hospital Notices of Non-Coverage (HINN) per established guidelines.