Case Manager

General Purpose


* Utilize clinical expertise and critical thinking skills to work collaboratively with residents, resident family/significant other, healthcare providers, insurers, community resources and other involved parties to develop and implement a plan of care that provides extraordinary care for the patient while being sensitive to costs and resources.

Essential Responsibilities


* Communicate regularly with residents and their family about Plans of Care, PT, OT and other treatment protocols.


* Attends and participates in morning meetings/stand up to facilitate communications with the team.


* Answer residents' questions about their care, treatment plans, illness progression and all other issues so they feel safe and secure in our care.


* Monitor and adjust residents' statuses based on changing needs and conditions.


* Organize and prioritize daily work by assessing new, current and discharging residents' needs in the area(s) of responsibility.


* Complete documentation as required.


* Performs utilization review activities to provide resident appropriate, timely and cost-effective care.


* Coordinate care with resident, care providers, facilities financial services, and third-party payers.


* Oversee all admissions and discharge activities.


* Coordinate referrals both to and from our facility.


* Ability to relate positively, effectively, and appropriately with residents, families, staff and professionals


* colleagues.


* Accurate charting and ability to complete necessary paperwork in a timely manner.


* Ability to work independently and exercise sound judgement in interactions with physicians, providers, payers and residents and their families.


* Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including residents/families/caretakers, physicians, nurses and other ancillary partners.


* Must have excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.


* Intermediate computer skills.


* Competence in maintaining professional, respectful, honest interactions with residents/families and staff and partners.


* Perform clinical assessments, care planning, and direct coordination of medical services when required by the role

Supervisory Requirements

This position has no supervisory responsibilities.

Qualification

Education and/or Experience


* Bachelor's Degree in Nursing or Social Work.

Registered Nurse (RN) license preferred.

Licensed (LVN or LPN) nurse acceptable.


* Two (2) years of clinical nursing experience preferred.


* Knowledge of Medicare, Medi-cal and Medicaid programs and benefits.


* PCC Knowledge preferred.


* Certificate as a certified Case Manager (CCM) a plus.


* Must maintain all required continuing education/licensing.


* Must remain in good standing with the Department...