Case Manager

PACS Group; Poinsettia Subdivision (TN); Presencial; USD 65 000 - 90 000; Tempo integral

Resumo da oferta

PACS Group is seeking a qualified nurse or social worker to coordinate patient care, develop plans of care, and work with families, physicians and payers. The role emphasizes cost-conscious, high-quality resident care in a collaborative team environment.

The role requires nursing or social work credentials, relevant clinical experience, and the ability to communicate clearly with residents, families, and healthcare professionals. Equal opportunity employer.

Qualificações

• Bachelor’s degree in Nursing or Social Work.
• RN license preferred; LVN/LPN acceptable.
• Two years of clinical nursing experience preferred.
• Knowledge of Medicare, Medi-Cal and Medicaid programs.
• CCM certification a plus.
• Continuing education/licensing must be maintained.

Responsabilidades

• Communicate plans of care with residents and families.
• Attend morning meetings to coordinate with the team.
• Address questions about care, plans, and illness progression.
• Monitor and adjust resident statuses based on needs.
• Prioritize daily tasks across areas of responsibility.
• Complete required documentation and charting.
• Perform utilization reviews for cost-effective care.
• Coordinate care with providers, facilities, payers.
• Oversee admissions and discharge activities.
• Coordinate referrals to and from the facility.
• Maintain professional, respectful interactions with all parties.

Conhecimentos

Communication

Documentation

Time management

Interpersonal skills

Formação académica

Bachelor's degree in Nursing

Bachelor's degree in Social Work

RN license preferred

Descrição da oferta de emprego

General PurposeUtilize clinical expertise and critical thinking skills to work collaboratively with residents, resident family/significant other, healthcare providers, insurers, community resources and other involved parties to develop and implement a plan of care that provides extraordinary care for the patient while being sensitive to costs and resources.Essential ResponsibilitiesCommunicate regularly with residents and their family about Plans of Care, PT, OT and other treatment protocols.Attends and participates in morning meetings/stand up to facilitate communications with the team.Answer residents’ questions about their care, treatment plans, illness progression and all other issues so they feel safe and secure in our care.Monitor and adjust residents’ statuses based on changing needs and conditions.Organize and prioritize daily work by assessing new, current and discharging residents' needs in the area(s) of responsibility.Complete documentation as required.Performs utilization review activities to provide resident appropriate, timely and cost-effective care.Coordinate care with resident, care providers, facilities financial services, and third-party payers.Oversee all admissions and discharge activities.Coordinate referrals both to and from our facility.Ability to relate positively, effectively, and appropriately with residents, families, staff and professionalscolleagues.Accurate charting and ability to complete necessary paperwork in a timely manner.Ability to work independently and exercise sound judgement in interactions with physicians, providers, payers and residents and their families.Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including residents/families/caretakers, physicians, nurses and other ancillary partners.Must have excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.Intermediate computer skills.Competence in maintaining professional, respectful, honest interactions with residents/families and staff and partners.Perform clinical assessments, care planning, and direct coordination of medical services when required by the roleSupervisory RequirementsThis position has no supervisory responsibilities.QualificationEducation and/or ExperienceBachelor’s Degree in Nursing or Social Work. Registered Nurse (RN) license preferred. Licensed (LVN or LPN) nurse acceptable.Two (2) years of clinical nursing experience preferred.Knowledge of Medicare, Medi-cal and Medicaid programs and benefits.PCC Knowledge preferred.Certificate as a certified Case Manager (CCM) a plus.Must maintain all required continuing education/licensing.Must remain in good standing with the Department of Public Health, License and Certification Division at all times.Physical DemandsPrimarily sedentary with frequent sitting, computer use, and documentation.Regular walking throughout the facility to meet with residents, families, and staff.Occasional standing during meetings and care conferences.Ability to lift and carry up to 20 pounds (files, binders, supplies).Clear verbal communication and vision required for chart review and resident interaction.Work EnvironmentThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.The noise level in the work environment is usually low to moderate.We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other legally protected status.