RN Case Manager Full Time
Company: Kindred Hospital Santa Ana
Location: Santa Ana
Posted on: September 18, 2023
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Job Description:
Description
At Kindred It Starts With Me.
Our commitment is to deliver excellence and an empathetic human
experience to every patient, every family member, every employee,
every time. We do this through our Core Values which help in
guiding our work every day.
Job Summary: The Case Manager II coordinates and facilitates the
care of the patient population through effective collaboration and
communication with the Interdisciplinary Care Transitions (ICT)
team members. Follows patients throughout the continuum of care and
ensures optimum utilization of resources, service delivery and
compliance with external review agencies. Provides ongoing support
and expertise through comprehensive assessment, care planning, plan
implementation and overall evaluation of individual patient needs.
Enhances the quality of patient management and satisfaction, to
promote continuity of care and cost effectiveness through the
integration of functions of case management, utilization review and
management, and discharge planning.
Essential Functions:
Care Coordination
Coordinates clinical and/or psycho-social activities with the
Interdisciplinary Team and Physicians.
Monitors all areas of patients' stay for effective care
coordination and efficient care facilitation.
Remains current from a knowledge base perspective regarding
reimbursement modalities, community resources, case management,
psychosocial and legal issues that affect patients and providers of
care.
Appropriately refers high risk patients who would benefit from
additional support. -
Serves as a patient advocate. - Enhances a collaborative
relationship to maximize the patient's and family's ability to make
informed decisions.
Demonstrates knowledge of the principles of growth and development
over the life span and the skills necessary to provide age
appropriate care to the patient population served.
Participates in interdisciplinary patient care rounds and/or
conferences to review treatment goals, optimize resource
utilization, provide family education and identified post hospital
needs. Collaborates with clinical staff in the development and
execution of the plan of care, and achievement of goals.
Coordinates with interdisciplinary care team, physicians, patients,
families, post-acute providers, payors, and others in the planning
of the patients' care throughout the care continuum.
Discharge Planning
Conducts comprehensive, ongoing assessment of patients - to provide
timely and safe discharge planning.
Provide comprehensive discharge planning for each patient. Utilizes
critical thinking to develop and execute effective discharge
planning.
Coordinates and communicates with patient/family efficiently and
effectively.
Utilization Management
Conducts medical necessity review for appropriate utilization of
services from admission through discharge.
Promotes effective and efficient utilization of clinical
resources.
Conducts timely and accurate clinical reviews, care collaboration
and coordination of continued stay authorization with payor.
Qualifications
Education:
Graduate of an accredited program required:
RN, BSN preferred
OR
Master of Social Work with licensure as required by state
regulations;
OR - - - - - - - - - - - -
Bachelor of Social Work with licensure as required by state
regulations
Licenses/Certification:
Healthcare professional licensure required as Registered Nurse or
Licensed Clinical Social Worker (LCSW) or Licensed Social Worker
(LSW) if required by state regulations.
Certification in Case Management preferred.
Experience:
Two years of experience in healthcare setting preferred.
Prefer prior experience in case management, utilization review, or
discharge planning.
Knowledge/Skills/Abilities/Expectations:
Knowledge of government and non-government payor practices,
regulations, standards and reimbursement.
Knowledge of Medicare benefits and insurance processes and
contracts.
Knowledge of accreditation standards and compliance
requirements.
Keywords: Kindred Hospital Santa Ana, Santa Ana , RN Case Manager Full Time, Executive , Santa Ana, California
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