Job Summary: The Case Manager is responsible for case management across the continuum of care utilizing an interdisciplinary approach to managing patient throughput in a fiscally responsible manner to achieve optimal outcomes. Responsible for the coordination of care, utilization review, acting as a resource to patients, family and/or significant others and staff; referrals to clinical social worker for psycho-social issues and complicated discharge planning issues; overseeing coordination of post-hospital care needs; interacting with insurance companies, medical groups, and community resources to ensure timely, efficient use of all services.
Licensure and Certification: Current CA RN license CMGT-BC certification preferred Current BLS provider card
Education: Diploma RN or BSN degree
Experience: Two years as a Case Manager in a behavioral health inpatient setting and/ or three years acute care experience. Strong interpersonal skills, leadership, negotiation skills, good leadership talent, and knowledge of hospital operations. General knowledge of the payer industry, resource management, reimbursement, and evidence-based clinical practice is essential.
Knowledge and Skills: Develops, maintains, and models professional, objective and value-oriented interpersonal skills. Continuously promotes a patient-centered philosophy. Maintains positive and proactive communication with patients, families, staff members, and physicians. Fosters team-building relationships. Excellent organizational skills and the ability to problem solve are essential.
Physical Demands - Clerical/Administrative Patient Care: Frequent sitting and standing/walking with frequent position change. Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and chest level. Occasional/intermittent reaching at or above shoulder level. Occasional/intermittent bending, squatting, kneeling, pushing/pulling, twisting, and climbing. Occasional/intermittent lifting and carrying objects/equipment weighing up to 25 pounds. Continuous use of near vision, hearing and verbal communication skills in handling telephone calls, interacting with customers and co-workers and performing job duties.
Key for Physical Demands Continuous 66 to 100% of the time Frequent 33 to 65% of the time Occasional 0 to 32% of the time