Processes the case utilizing Paradigm’s outcome management model and tools  Obtains written authorization for case management services as well as release of information  Assesses the client/family to identify their strengths and resources; problems; psychosocial, financial, and medical history; current status; diagnosis; prognosis; functional status; goals; current treatment plan; and needs  Develops a plan of care with Paradigm’s model through interdisciplinary collaboration, which identifies realistic short- and long-term goals  Identifies, secures, and coordinates the services and resources to implement the plan  Monitors services being provided for continued appropriateness and reports to Paradigm and insurance carrier  Evaluates the client’s progress, the plan, and the appropriateness of the services provided, with modifications as necessary  Provides ongoing instruction to the client and family regarding the injury/disease process, treatment options, and present care  Promotes the client’s/family’s self-advocacy skills to achieve maximum self-sufficiency  Has knowledge of the benefit package as well as all available funding sources and systems of care and coordinates with the payer for authorization of payment. Provides for in-depth reporting of outcomes encompassing clinical, functional, financial, and customer satisfaction areas  Demonstrates effective, accurate, and timely verbal and written communication in all work situations  Identifies and discloses all situations which might result in exposure to legal liability and/or are indicative of poor quality care negatively affecting the client  Frequently requires travel to patient appointments.  Performs other related duties as assigned in accordance with the necessary job function

Education and/or Experience:  Registered nurse  BSN preferred  CCM or equivalent certification


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