Relief Case Manager Ii

2 weeks ago

Palo Alto, United States Lucile Packard Children's Hospital Full time

**CRONA**

**0.3 FTE, 8 Hour Day Shift**

At Stanford Children's Health, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with continuing education and state-of-the-art facilities, like the newly remodeled Lucile Packard Children's Hospital Stanford. And it's why we need caring, committed people on our team - like you. Join us on our mission to heal humanity, one child and family at a time.

**Job Summary**:

- This paragraph summarizes the general nature, level and purpose of the job._

**Essential Functions**:

- The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned._
- Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patient rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings._

Must perform all duties and responsibilities in accordance with the Service Standards of the Hospital(s).

COORDINATION OF CARE
- Manages each patient's transition through the system and transfers accountability to the appropriate person upon entry into another clinical service or discharge.

DISCHARGE PLANNING
- Coordinates and facilitates timely implementation of discharge plans for assigned patients with complex needs in collaboration with other interdisciplinary team members; arranges follow-up care as appropriate.

EDUCATION/CONSULTATION
- Acts as an educational resource and provides consultation to patients and their families, hospital medical personnel regarding the discharge planning process and applicable regulatory requirements; educates the staff on case management; and provides specific information related to case types.

LEAD WORK
- May lead the work of administrative/clinical support staff responsible for assisting with case management for an assigned patient caseload.

OTHER
- Participates in department program planning, goal setting, systems development and process improvement; participates in department and hospital committees and task forces; develops and maintains documentation of findings, discharge arrangements, and actions taken according to departmental guidelines; prepares and maintains records as required; collects, analyzes and reports on data for utilization, quality improvement, compliance, and other areas as assigned.

PATIENT ASSESSMENT/PLAN OF CARE
- Functions as a resource to and collaborates with physicians, social workers, nurses, and other interdisciplinary team members to assess, plan, and coordinate patient care needs and/or performs patient assessment and develops a plan of care to assure consistent, timely, and appropriate care is provided in a patient-focused manner.

QUALITY IMPROVEMENT
- Participates in quality improvement activities by identifying opportunities for improvement in such areas as clinical outcomes, utilization of resources and concurrent data collection; participates in clinical process improvement teams within the department, service lines, and hospital.

THIRD-PARTY REIMBURSEMENT
- Collects, analyzes, reports and reviews patient information with third-party payors to assure reimbursement for patient services/procedures. Communicates with review organizations/payers to provide requested clinical and psychosocial information to assure reimbursement.

UTILIZATION REVIEW
- Reviews prospectively, concurrently and retrospectively all inpatients for appropriateness of admission, level of care, and determines appropriate length of stay. Monitors patients' length of stay and collaborates with physicians to ensure resource utilization remains within covered benefits and are appropriate in relationship to the patient's clinical and psychosocial needs; plans and implements (through multi-disciplinary meetings or rounds) strategies to reduce length of stay, reduce resource consumption, and achieve positive patient outcomes analyzes and addresses aggregate variances as well as variances from individual patients and shares this information with staff, physicians, and administration.

**Minimum Qualifications**:

- Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying._

**Education**: Bachelor's Degree in Nursing from an accredited college or university

**Experience**: Two (2) years of progressively responsible and di

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