Medical Case Manager job description
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What does a Medical Case Manager do?
The Medical Case Manager plays a crucial role in coordinating and overseeing the integrated delivery of healthcare services for patients. This position is essential in ensuring optimal patient outcomes by managing treatment plans and facilitating communications between healthcare providers, patients, and families.
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What are the Key Responsibilities of Medical Case Manager
- Assess patient's healthcare needs and create comprehensive care plans.
- Coordinate with medical professionals and services to execute treatment plans.
- Monitor and evaluate the effectiveness of care plans and make adjustments as needed.
- Advocate for patient's needs and rights within the healthcare system.
- Provide education and support to patients and their families regarding care plans.
- Manage transitions of care to ensure continuity and quality.
- Document and maintain accurate patient records and interactions.
- Facilitate communication between patients and the healthcare team to ensure understanding and collaboration.
- Ensure compliance with healthcare regulations and standards.
What are the Skills and Requirements for a Medical Case Manager?
- Strong clinical knowledge in medical care and patient management.
- Ability to build rapport and communicate effectively with patients and healthcare teams.
- Excellent organizational and documentation skills.
- Proficient with Electronic Health Record (EHR) systems.
What are the KPIs to track for Medical Case Manager?
The Medical Case Manager's performance is evaluated based on patient satisfaction scores, reduced hospital readmission rates, successful implementation of care plans, and effective coordination among healthcare providers.
Patient Satisfaction
Maintain or improve patient satisfaction scores.
Care Plan Implementation
Successful adherence and modification of care plans to fit changing patient needs.
Reduced Readmissions
Decrease in the rate of hospital readmissions through effective care management.
Reports to
Director of Case Management
Collaborates with
Physicians, Nurses, Social Workers
Leads
None
Are any specific tools or software required for the Medical Case Manager role?
- Electronic Healthcare Records (EHR)
- Microsoft Office Suite
- Case management software
What is the qualification of Medical Case Manager?
Bachelor's degree in Nursing, Social Work, or related healthcare field; 3-5 years of experience in case management or healthcare coordination.
