Case Manager

2 months ago

Palo Alto, United States MFS Talent Full time
Job Description
JOB DETAILS

  • Shifts Available: Days - 8-6:30pm, may need to work on weekends, 40 hours/week
  • Work Location: Onsite; Palo Alto, CA
Duties and Responsibilities
  • Coordination of Care -- Collaborate with healthcare teams, including physicians, nurses, social workers, and other professionals, to ensure continuity and appropriateness of care. Facilitate communication and coordination among healthcare providers, patients, and payers to optimize patient outcomes and minimize unnecessary healthcare services. 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.
  • Patient Assessment / Plan of Care -- Functions as a resource to and collaborates with physicians, social workers, nurses, and other interdisciplinary teams 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.
Requirements

Education Qualifications
  • Bachelor's Degree from an accredited college or university.
Licenses and Certifications
  • RN - Registered Nurse
  • BLS - Basic Life Support
Experience
  • Three (3) years of progressively responsible and directly related work experience. Preferred
  • Nice to have experience in inpatient case management
Benefits
  • Medical/Dental/Vision
  • 401k

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