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Specialty RN Case Management
2 months ago
The Specialty RN collaborates closely with a designated group of healthcare providers to address the unique needs of patients with chronic conditions. The composition of the care team varies based on the specific chronic illness. Responsibilities encompass evaluating patient requirements and crafting tailored care management strategies to meet those needs. In partnership with the healthcare team, the RN executes the care plan by facilitating access to medical services across various providers and disciplines, overseeing patient care, arranging transportation when necessary, identifying cost-effective solutions, and recommending alternative care options while promoting self-management. This role is primarily supportive and requires effective collaboration with a multidisciplinary team.
Key Responsibilities:- Assess and identify patient needs, collaborating with Primary Care Physicians, Specialists, and other healthcare professionals to develop comprehensive case management plans.
- Continuously monitor and assess the effectiveness of care management strategies, making adjustments as required.
- Facilitate an interdisciplinary approach to ensure seamless continuity of care, including managing utilization, coordinating transfers, discharge planning, and securing necessary authorizations for external services.
- Serve as a clinical liaison with external agencies, including County CCS, non-network facilities, and third-party administrators.
- Generate reports, communicate changes in programs to relevant staff, and develop protocols in line with state regulations.
- Act as an advocate and educator for patients, ensuring they possess the knowledge to manage their conditions and actively participate in their care plans.
- Create individualized education plans for patients and families focused on self-management, providing disease-specific education.
- Develop and update training materials, presenting them to staff, members, and families, while facilitating patients' return to daily activities through appropriate referrals.
- Consult with both internal and external healthcare providers regarding ongoing care, treatment, hospitalization, or referrals to support services.
- Coordinate transportation and housing arrangements for patients as needed, ensuring effective communication of clinical and benefit information.
- Engage in data collection and analysis regarding clinical outcomes and patient satisfaction, contributing to the development and monitoring of care strategies.
- Interpret regulations, health plan benefits, and policies for members, healthcare providers, and external agencies.
Experience
- At least two (2) years of clinical experience as a Registered Nurse in an acute or outpatient care environment is required.
- Bachelor's degree or equivalent experience (four years) is required.
- Registered Nurse License (California)
- Basic Life Support Certification
- Proven ability to apply principles and practices of care coordination, utilization management, and case management.
- Familiarity with regulatory standards and accreditation requirements (TJC, Medicare, Medi-Cal, etc.).
- Strong communication, interpersonal, critical thinking, and problem-solving skills are essential.
- Proficiency in computer skills is required.
- Bilingual (English/Spanish) Level II is mandatory.
- Certification in Case Management or a related specialty is preferred.
- Bachelor's degree in nursing or a healthcare-related field is preferred.
- Experience in complex case management, including Medicare and Medi-Cal.
- Must have successfully completed or passed the bilingual assessment within the last year or be active in the QBS program.
- This role encompasses responsibilities for the Special Needs Program and may also involve Geriatrics and Palliative Care.
- Availability to work on Saturdays is required.
