Case Manager Skills Checklist Date:* Name: (First, MI, Last)* Email AreaCollect and assess patient information pertinent to patient's history, condition, and functional abilities in order to develop a comprehensive, individualized care plan that promotes wellness, appropriate utilization, and cost-effective care and services.* N/A Inexperienced Limited Experienced Experienced Highly Experienced Develop, implement, and coordinate case management action plan for achieving specified patient goals as determined by the case management action plan. Coordinate necessary resources to achieve goals and objectives.* N/A Inexperieenced Limited Experience Experienced Highly Experienced Monitor and evaluate appropriateness of case management action plan, assess progress toward meeting goals, and modify the plan to help achieve desired patient outcomes.* N/A Inexperienced Limited Experience Experienced Highly Experienced Support outreach activities as needed to members, clients, providers and others.* N/A Inexperienced Limited Experience Experienced Highly Experienced Perform concurrent review of patients admitted to hospitals.* N/A Inexperienced Limited Experienced Experienced Highly Experienced Serve as a resource to assist patient and patient's family in accessing appropriate providers, facilities, and community resources for their behavioral healthcare needs.* N/A Inexperienced Limited Experience Experienced Highly Experienced Review referral and preauthorization requests for appropriateness of care within contract guidelines.* N/A Inexperienced Limited Experience Experienced Highly Experienced Identify high exposure cases, case management or utilization review issues, pertinent inquiries, problems and decisions that may require review.* N/A Inexperienced Limited Experience Experienced Highly Experienced Identify and negotiate with appropriate vendors to provide services* N/A Inexperienced Limited Experience Experienced Highly Experienced Serve as primary resource to patient and family members for questions and concerns related to the health plan and navigating through the health systems issues.* N/A Inexperience Limited Experience Experienced Highly Experienced Track and manage provider claims related to case load.* N/A Inexperienced Limited Experience Experienced Highly Experienced Identify catastrophic or high exposure cases.* N/A Inexperienced Limited Experience Experienced Highly Experienced Thorough knowledge and understanding of medical procedures, diagnoses, care modalities, and procedures codes.* N/A Inexperienced Limited Experience Experienced Highly Experienced Thorough knowledge of community services, providers, vendors and facilities available to assist members.* N/A Inexperienced Limited Experience Experienced Highly Experienced Ability to use computerized systems for data recording and retrieval* N/A Inexperienced Limited Experience Experienced Highly Experienced Experience in case management, including cases that require rehabilitation treatment.* N/A Inexperienced Limited Experience Experienced Highly Experienced Experience in case management, including cases that require home health treatment.* N/A Inexperienced Limited Experience Experienced Highly Experienced Excellent communication and negotiation skills, both verbal and written.* N/A Inexperienced Limited Experience Experienced Highly Experienced Experience in case management, including cases that require hospice treatment. N/A Inexperienced Limited Experience Experienced Highly Experienced Basic math skills including percentages, ratios, graphing and spreadsheet skills.* N/A Inexperienced Limited Experience Experienced Highly Experienced Making decisions for care outside contractual benefits that are mutually beneficial and cost-effective.* N/A Inexperienced Limited Experience Experienced Highly Experienced BLS MM slash DD slash YYYY ACLS MM slash DD slash YYYY Telemetry Certificate MM slash DD slash YYYY ONS Chemo/Biotherapy Certification MM slash DD slash YYYY Other Chemo Certification MM slash DD slash YYYY Areas of Expertise:Consent* By submitting this form, I agree to all terms and conditions and agree to authorize consent PhoneThis field is for validation purposes and should be left unchanged.