Instructions:

Please rate your experience / frequency (within the last year) using the following scale (check the appropriate boxes below):

  • 0 = No Experience / Observed Only
  • 1 = Limited Experience / Rarely Done (<6 times/year)
  • 2 = May Need Some Review / Occasionally Done (1 - 2 times/month)
  • 3 = Experienced / Frequently Done (daily or weekly)
    		•
    AGE OF PATIENTS CARED FOR
    Newborn/Neonate (birth to 30 days)
    Infant (31 days to 12 months)
    Toddler/Preschool (13 months to 5 years)
    School Age Child/adolescent (6 years to 18 years)
    Young Adults/Middle Adult (19 years to 64 years)
    Older Adults/Elderly (65+ years)
    SKILLED ENVIRONMENTS
    Acute Care/ Hospital
    Managed Care
    SNF/ Long Term Care
    Home Health
    Outpatient
    GENERAL CASE MANAGEMENT
    Written Communication Skills
    Verbal Communication Skills
    Basic Negotiation Skills
    Job Related Computer Skills
    Ability to Prioritize
    Knowledge of Community Health Care and Vocational Services
    Ability to Properly Maintain Records
    Knowledge of Medical Billing Procedures
    Ability to Work Effectively in All Situations
    Ability to Assess, Plan, Implement and Evaluate Individual Patient Care Programs and Treatment Plans
    Ability to Gather Data, Compile Information and Prepare Reports
    Ensure Outcomes are Met within an Appropriate Length of Stay
    Coordinate and Monitor Services, Including Comprehensive Tracking of Client Activities in Relation to Care Plan
    Conduct Medication and Mental Status Assessment and Determine Required Level and Frequency of Service
    Document All Client Encounters
    Complete and Submit Billing Documentation as Appropriate
    Identify and Provide Emergency Crisis Services as Necessary
    Make Immediate Clinical Assessments and Respond According to Accepted Crisis Intervention Methods and Techniques; Coordinate Other Services as Appropriate
    Ability to Develop and Implement Action Plans for Health Centers to Improve Performance
    Ability to partake in interdisciplinary rounds and working with various members of the care team
    Knowledge of "Do Not Use Abbreviations"
    Knowledge of current Joint Commission National Patient Safety Goals
    Knowledge/familiarity with HCAHPS scores
    EXPERIENCE
    Disability Review
    Long Term/ Short Term Disability Case Management
    Workers Compensation Case Management
    Telephonic Case Management
    Pre Certification/ Pre-Admission Certification
    Catastrophic Case Management
    Concurrent Review
    Continued Stay Review
    Retrospective Review
    MCM - Medical Case Management
    Discharge Planning
    ISD-A Interqual Criteria for Hospital Admissions
    Intensity of Service - Diagnosis & Therapeutic Services
    Discharge Screens - Specific Indicators of Patients Ability
    Appropriateness of Care - Special Diagnosis and Therapeutic Procedures
    DRG - Diagnosis Related Grouping (exempt & non exempt states)
    ICD - 9- CM
    CPT
    SIMS - Interqual- Criteria for SSO Waiver
    Milliman and Robertson Criteria
    PPR - Prospective Procedure Review
    PA - Physician Advisor
    Prior Authorization
    Utilization Review
    Utilization Management
    EMR Systems
    Other EMR Systems: