Case Manager. Team Manager. Nationwide

Transcription

1 Position: Case Manager Business Group: Claims Management Reporting to: Team Manager Location: Nationwide Approved: Date: September 2010 About ACC ACC works to reduce the overall incidence and impact of injury in New Zealand, through delivery of injury prevention, rehabilitation and compensation services. ACC is a crown entity and is governed by a Board appointed by the Minister for ACC. The ACC Scheme provides comprehensive, no fault cover for accidental injury for all New Zealand citizens, residents and visitors. When injury does occur, ACC gives people access to a range of medical, financial and other support aimed at helping them return to work and everyday life as quickly and fully as possible. ACC s Vision and Guiding Principles ACC s vision is to lead the world in accident prevention, care and recovery. Underlying the vision is a set of guiding principles which help to inform how the organisation operates. These principles are that ACC is working with all New Zealanders to: ensure the financial sustainability of the Scheme for future generations achieve the best possible delivery of New Zealand's unique accident compensation scheme reduce the personal and economic impact of accidental injury contribute to a healthy kiwi way of life. ACC s outcomes ACC s vision is supported by three outcomes (long-term goals) that help describe the benefits the ACC Scheme delivers to New Zealanders: Ensure the Scheme is financially sustainable and represents value for money Rehabilitate injured people in New Zealand more efficiently Reduce the incidence and severity of injury where it is cost-effective to do so

2 ACC s Values Honour people as People Freedom to succeed Pride in what we do Position Summary The Case Manager role provides a needs based service to people with high risk and serious injury, in order to achieve the best possible outcome and durable independence. The Case Manager is responsible for providing effective rehabilitation to enable the individual to take responsibility for their life and future, through informed and participative decision making and goal setting. A critical component of the position is the development of case management plans that provide a predictive, planned and facilitated process to co-ordinate and direct the services needed to achieve durable independence. The Case Manager must also assess and monitor individual clients to ensure that the desired outcomes are achieved. An integral part of the role is developing positive relationships with clients, employers, and service providers. Accountabilities Key Result Areas Assessment and facilitation Cultural and Linguistic Competencies (if specified) Meet with clients in the context of a comprehensive case management approach to determine vocational, rehabilitation and compensation needs to achieve a durable outcome. (This will include assessment of medical, vocational, social, economic, compensation and rehabilitation needs). Utilise case management practices to provide assessments of client information and to determine individual case needs and appropriate courses of action for high risk and seriously injured clients. Where appropriate, provide information to clients on linkages with other agencies that would facilitate their recovery. Ability to speak language/s other than English at a conversational level as required by ACC customers. Ability to operate effectively in non-english speaking communities. Case Management Plan Undertake early intervention to ensure the case management plan (individual rehabilitation) integrates all services required to achieve realistic and sustainable outcomes and is supported by the client, medical providers and where appropriate, the employer, when return to work is the objective.

3 Review Prepare review submissions as required. Attend review hearings as required. Costs Monitor and review costs associated with case management plans according to the policies of the Corporation. Evaluate actual costs against projected costs and outcomes and discuss these with all parties involved. Collate activity data for performance management and quality improvement purposes. Research and Special Projects Assist as directed in research and special projects designed to further ACC s case management objectives and future service delivery planning. Professional Advice Provide professional advice to ACC in the planning and development of ACC s rehabilitation initiatives. Health Liaison Development of working relationships with key personnel in the District Health Boards. Manage requests from Hospitals regarding early intervention strategies, including immediate referral to the appropriate person in the branch for allocation of the claim to a case manager to arrange referrals, case conferences and post discharge requirements. Ensure that inquiries (where appropriate) and or approval requests are forwarded to the correct person in the branch for action. Pass on to the appropriate person any inquiries that do not relate to the clients in the branch. Other duties Comply with WorkSafe policies and procedures and take responsibility for hazard identification within own work area. Contribute to and assist the Branch Manager with quality assurance control of branch business excellence plans including on-going reviews of branch processes and implementation of new initiatives. Undertake other duties as required from time to time in order to assist the business and facilitate the smooth running of the organisation.

4 Key Working Relationships External Clients Employers Client advocates Family of clients Employee Representatives Health Professionals Service Providers Others who provide services or assistance to ACC Internal Branch Managers Case Managers Other Branch staff Staff Number of direct reports: Total number of employees in this Cost Centre: Nil Education, Skills, Knowledge, Experience A tertiary qualification in rehabilitation, health or related discipline. (Work experience equivalent to the stated qualification levels will be considered). Work experience in rehabilitation, health or other relevant environment. Excellent interpersonal skills, particularly in relation to negotiating with clients, health professionals, service providers and employers. Proven negotiation and conflict resolution skills. Ability to communicate effectively in writing, orally and when presenting information to others. Sound knowledge of the physiological and psychological affects of personal injuries caused by accidents and the impact of injury on work activities and activities of daily living. Good working knowledge of medical, social and vocational rehabilitation principles and protocols. Ability to sensitively balance cost benefit and other considerations in appraising case management plans and services from both a program and individual client perspective. Experience in working as part of a multi-disciplinary team incorporating professional and non-professional persons. High level of motivation and initiative. Sensitivity to issues related to equity, people with disabilities, and cultural and social needs. Ability to be self managing and plan and organise work in a manner that ensures the time frame involved in case loads are managed. Current full driver s license. Core Competencies:

5 Interpersonal skills Relates well to all kinds of people, inside and outside the organisation. Builds appropriate rapport. Builds constructive and effective relationships. Uses diplomacy and tact. Can diffuse even high-tension situations comfortably. Customer focus Is dedicated to meeting the expectations and requirements of internal and external customers. Gets first-hand customer information and uses it for improvements in products and services. Acts with customers in mind. Establishes and maintains effective relationships with customers and gains their trust and confidence. Drive for results Enjoys working hard. Is action-orientated and full of energy. Can be counted on to exceed goals successfully. Steadfastly pushes self and others for results. Not fearful of acting with a minimum of planning. Seizes more opportunities than others. Flexibility Can effectively cope with change. Can shift gears comfortably. Can decide and act without having the total picture. Isn t upset when things are up in the air. Doesn t have to finish things before moving on. Can comfortably handle risk and uncertainty. Innovation Comes up with a lot of new and unique ideas. Can project how potential ideas may play out. Has good judgement about which creative ideas and suggestions will work. Easily makes connections among previously unrelated notions. Tends to be seen as original and value-added in brainstorming. Integrity Adheres to a set of core values and beliefs during both good and bad times. Acts in line with values. Practices what he/she preaches. Is seen as a direct, truthful individual.

6 Keeps confidences. Admits mistakes. Self-development Knows personal strengths, weaknesses, opportunities and limits. Gains insight from mistakes. Is open to criticism. Is personally committed to and actively works to continuously improve himself / herself. Understands that different situations and levels may call for different skills and approaches. Learns quickly when facing new problems.

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