Case Manager II

Job Requirements Delivers comprehensive, patient-centered care management through expert assessment, individualized care planning, and coordination across the continuum of care. Manages patients with increased clinical, psychosocial, and system complexities and demonstrates specialized expertise within an assigned practice area. Serves as a resource for complex cases, promotes evidence-based practices, and provides mentorship, coaching, and guidance to team members. Working collaboratively with patients, caregivers, providers, payers, and community partners, supports safe transitions of care, optimizes resource utilization, and improves patient outcomes. Contributes to departmental quality initiatives, maintains regulatory compliance, and supports professional development within the care management team. Delivers comprehensive, patient-centered care management through expert assessment, individualized care planning, and coordination across the continuum of care. Manages patients with increased clinical, psychosocial, and system complexities and demonstrates specialized expertise within an assigned practice area. Serves as a resource for complex cases, promotes evidence-based practices, and provides mentorship, coaching, and guidance to team members. Working collaboratively with patients, caregivers, providers, payers, and community partners, supports safe transitions of care, optimizes resource utilization, and improves patient outcomes. Contributes to departmental quality initiatives, maintains regulatory compliance, and supports professional development within the care management team. Primary Responsibilities The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job responsibilities performed. Perform advanced holistic assessments of patients with complex clinical, psychosocial, behavioral, and resource needs to identify and address barriers to optimal outcomes. Develop and oversee complex care plans, ensuring coordination across providers, settings, and community resources. Manage a caseload of patients requiring advanced care coordination, problem-solving, and transition planning. Serve as a subject matter expert within an assigned practice area and provide consultation on complex patient situations. Promote evidence-based practices and support consistent application of case management standards throughout the department. Mentor, coach, and support the professional development of case management colleagues. Facilitate collaboration among patients, caregivers, physicians, payers, and community partners to achieve quality and cost-effective outcomes. Ensure compliance with regulatory requirements and organizational policies while supporting audit readiness and quality initiatives. Analyze trends, outcomes, and performance data to identify opportunities for improvement in patient care and care coordination processes. Lead departmental projects, practice improvements, or educational efforts within the assigned area of expertise. Perform all other duties as assigned. Education & Experience - Required Associate degree in Nursing with active specialty certification, or Bachelor of Science in Nursing, or Master's degree in Physical Therapy. Current Maryland unrestricted licensure as a Registered Nurse (RN) or Physical Therapist (PT). Two (2) years of case management experience. Membership in a professional healthcare or case management organization. Demonstrated expertise within an assigned clinical, operational, or specialty practice area. Ability to independently manage complex patient situations and coordinate care across multiple settings and providers. Experience mentoring, coaching, educating, or serving as a resource to colleagues. Education & Experience – Preferred Bachelor's degree or higher in Nursing. CCM, ACM, CMAC, or other nationally recognized case management certification. Five (5) years of healthcare or case management experience. Experience leading projects, quality initiatives, or process improvement efforts. Demonstrated involvement in professional presentations, education, committee work, or practice-development activities. Knowledge, Skills, & Abilities Advanced case management practices and complex care coordination strategies Specialty practice area expertise. Resource utilization, population health, and quality improvement methodologies. Regulatory requirements affecting complex patient populations. Management of complex clinical and psychosocial cases. Critical thinking and problem-solving in ambiguous situations. Mentoring and coaching peers. Data analysis and performance improvement. Facilitation of difficult interdisciplinary discussions. Independently manage highly complex patient situations. Serve as a resource and consultant to colleagues. Lead implementation of best practices within an assigned area. Influence care decisions without direct authority. #J-18808-Ljbffr