Case Manager Acute - Part Time

Bargaining Unit: EAP

Rate of Pay: $73.72/hour + DOE

SummaryEnsures quality patient care is provided in a cost efficient manner, inclusive of tracking resource utilization and decreasing unnecessary hospital stays. The position is accountable for providing concurrent and retro reviews of the patient medical records using current guidelines. Case Management staff are experienced and motivated towards implementing effective quality and utilization management systems.

Essential Duties and Responsibilities

• Screens all hospital admissions and reviews daily census.
• Reviews the clinical records of all admissions using InterQual to determine medical necessity for outpatient or inpatient admission and continued stay
• Contacts Review Organizations as required and documents communication appropriately in the patients record
• Screens all hospital admissions against the high risk screening criteria for the need for discharge planning evaluation
• Knowledge of local community resources
• Coordinates planning for post hospital care using a multidisciplinary approach
• Demonstrates ability to utilize various financial resources agencies to assist emergency room and acute care patients in need.
• Participates in the UM functions of pre-authorizations of inpatient/outpatient services
• Performs transfer coordination.
• Works adjunctively, when requested, with ECC personnel in the coordination or problem solving of a residents care or discharge plan
• Leads and coordinates patient care conferences.
• Acts as a resource person in the area of case management.
• Promotes improvement in patient care through endorsement of quality assessment/improvement process.
• Performs ongoing nursing and medical staff case management education including appropriate levels of care.
• Demonstrates System Values in performance and behavior.
• Complies with System policies and procedures.
• Other duties as may be assigned.

QualificationsTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Supervisory ResponsibilitiesNo supervisory responsibilities.

Minimum Education/ExperienceAssociate's Degree graduation from a National League of Nursing (NLN), Commission on Collegiate Nursing Education (CCNE) or equivalent school of nursing. Must have completed a nursing education program that included clinical experiences with actual patients under the supervision of qualified faculty

and 1-2 years relevant experience

Required Licenses/CertificationsCalifornia Registered Nurse (RN)

• Upon hire

Nevada Registered Nurse (RN)

• Upon hire

Basic Life Support (BLS) for Healthcare Providers

• Upon hire

BLS: Employee will be enrolled in the Resuscitation Quality Improvement (RQI) Basic Life Support (BLS) Entry or Prep Curriculum (depending on their previous BLS certification).

• Within 3 months of hire into job

Other Experience/Qualifications

Preferred:

• Bachelor's Degree in nursing (BSN) with two years' experience in the acute hospital setting as a Case Manager.
• Will consider an Associate degree in nursing with five years’ work experience in the acute hospital setting as a Case Manager.
• Case Management Certification