Case Management Skills Checklist

First name:	Last name:
Phone:	Email:
SSN (last 4 only):	Date: (MM/DD/YYYY)

Key - for each box mark:

Limited or no experience
Somewhat experienced but may need review
Can function independently
Competent to supervise

	1	2	3	4
CASE MANAGER SPECIFIC SKILLS
Knowledge of community health care and vocational services
Ability to properly maintain records
Knowledge of medical billing procedures
Strong interpersonal and communication skills and the ability to work effectively in all situations
Ability to monitor, assess and record client progress against care plan and make adjustments accordingly
Ability to assess mental status in clients and to develop individual treatment goals and plans
Ability to plan, implement and evaluate individual patient care programs
Ability to gather data, compile information and prepare reports
Ensure outcomes are met within an appropriate length of stay
Coordinate and monitors services, including comprehensive tracking of client activities in relation to care plan
Assist clients in developing goals and areas of need, and assists in developing treatment plans which are assessed regularly
Conduct medication and mental status assessment and determines required level and frequency of service
Document all client encounters and contracts made on behalf of clients
Complete and submit billing documentation as appropriate
Maintain comprehensive client files, which may include documents held for safekeeping on behalf of the client
Identify and provide emergency crisis services as necessary
Make immediate clinical assessments and respond according to accepted crisis intervention methods and techniques; coordinates other services as appropriate
Assess patients, evaluate effectiveness of care plan and progress made by client
Participate in patient treatment planning and case review with patient care providers
Ability to develop and implement action plans for health centers to improve performance
EXPERIENCE
Concurrent Review
Utilization Review
Utilization Management
Prior Authorization
Disease Focused Case Management
Catastrophic Case Management
Home Health
Work Comp
COMPUTER SKILLS
Job related computer knowledge
Interqual - McKesson software familiarity
Other:
Other:
Other:
Other:

Age Specific Experiences and Certifications

Age Specific Experiences	Infants and Toddlers (birth-2 years)	Children (3-12 years)	Adolescent (13-18 years)	Young Adult (19-39 years)	Middle Adults (40-64 years)	Older Adult (65+ years)
1. Knows the normal growth and development for each age group and adapts care accordingly.
2. Knows the different communication needs for each age group and changes communication methods and terminology accordingly.
3. Knows the different safety risks for each age group and alters the environment accordingly.
4. Knows the different medications, dosages, and possible side effects for each age group and administers medications accordingly.

The information I have provided in this skills checklist is true and accurate to the best of my knowledge. I hereby authorize Fortus Group to release this information to client facilities in relation to consideration of my employment.