Case Manager

Salinas Valley Health; Salinas (CA); On-site; USD 101,000 - 123,000; Full time

Job summary

Salinas Valley Health in Salinas, CA is seeking a Case Manager to perform utilization review and discharge planning for assigned patients. The role emphasizes evaluating medical necessity, level of care, and coordination of discharge plans to ensure continuity of care for patients and families.

Under the direction of the Case Management leadership, you will refer cases not meeting criteria to physician reviewers, monitor length of stay, and collaborate with hospital staff to manage care

Qualifications

• ASN required; BSN preferred.
• Current California RN license.
• BLS/Healthcare Provider status as per American Heart Association.
• Three years acute medical-surgical nursing and at least one year of utilization review or discharge planning experience in an acute care hospital.

Responsibilities

• Perform Utilization Review and Discharge Planning for assigned patients.
• Analyze medical records for medical necessity, level of care and appropriate utilization of hospital services.
• Assist patients and families in discharge planning and aftercare planning.
• Identify discharge resources and develop formal discharge plans.
• Refer cases not meeting utilization screening criteria to physician reviewers.
• Initiate discharge planning and facilitate discharge teaching.
• Coordinate multidisciplinary infant, pediatric and adolescent care teams in discharge planning conferences.

Skills

RN License

Discharge planning

Utilization review

Acute care

Education

ASN

BSN preferred

Job description

Case ManagerWe use cookies to enhance your browsing experience, serve personalized ads or content, and analyze our traffic. By clicking \"Accept All\", you consent to our use of cookies.### Case ManagerApply: Salinas, CA: Full time: Posted Yesterday: SVH-103653**It's fun to work in a company where people truly BELIEVE in what they're doing!***We're committed to bringing passion and customer focus to the business.*## ## Department:Case Management**Job Description**Under the direction of the Director and or the Manager of Case Management performs Utilization Review and Discharge Planning for assigned patients. Analyzes medical record for medical necessity, level of care and appropriate utilization of hospital services. Provides assistance to patients and their family in planning discharge and after care of patients. Assesses needs, identifies resources to support discharge requirements and develops formal discharge plans. * Uses knowledge and skills to ensure a high degree of continuity of care.* Refers all cases, which fail to meet utilization screening criteria to physician reviewers.* Determines and monitors appropriate length of stay.* In collaboration with hospital personnel, manages care delivery.* Screens all patients for potential discharge needs.* Initiates discharge planning and facilitates discharge teaching.* Identifies resources for follow-up care and evaluate effectiveness of discharge planning. **NICU Specific Specifications:*** Participates in direct patient care by ensuring appropriate discharge information for each NICU infant.* Ensure that each infant discharged from the NICU have a follow-up by a primary care physician and provide when appropriate follow-up care in a specialized program for the High Risk Infant. Determine if infant meets high risk for follow-up criteria and advise parent/guardian of process. Make appointments at specialty clinics for infant.* Identify discharge needs at admission and arrange for any durable medical equipment the physician has ordered.* Ensure that each infant discharged has the opportunity to be seen by a Home Health Agency Nurse following discharge.* Referral to CCS when infant meets qualifying criteria. Instruct parent/guardian on CCS referral process.* Under direction of the Director of Case Management, develops and implements discharge planning standards of care for the neonatal unit.* Pursues new knowledge in neonatal discharge planning by reviewing and evaluating current literature, attending and/or presenting at conferences in order to maintain a high level of expertise.**Pediatric Specific Duties:*** Participates in direct patient care by ensuring appropriate discharge information for each pediatric patient.* Ensures communication with appropriate primary care physician and community agencies as well as when appropriate with. + CCS programs; identification and appropriate referrals + CCS Special Care Centers + Regional Centers whose care includes the needs of the infant, child or adolescent post acute hospital discharge.* Ensures provision of a written discharge information that is culturally and linguistically appropriate be given to the parent, legal guardian, and or primary care giver at time of discharge and shall include but not be limited to: + Diagnosis + Medications + Follow-up appointments with primary physicians and community agencies as listed above. + Instructions on medical treatments to be administered at home. + Copies of the above written discharge instructions to be given to the primary physician.* Ensures the provision of teaching the parent, legal guardian or primary caregiver the medical needs of the infant, child or adolescent including the use of necessary technology to support post discharge care.* Coordinates the appropriate multidisciplinary infant, pediatric and/or adolescent healthcare team members in discharge planning conferences.* Performs other duties as assigned. **Education:** Associates of Science in nursing (ASN) required, BSN preferred. **Licensure:** Current California RN license. Current BLS/Healthcare Provider status as per American Heart Association standards. \\*See unit specific certification requirements below. **Experience:** Three (3) years acute medical surgical nursing and at least one (1) year of utilization review, case management, or discharge planning experience in an acute care hospital required unless posting specifies as a training position. **Pay Range**: The hourly rate for this position is $73.62- $89.49. The range displayed on this job posting reflects the target for new hire salaries for this position.**Job Specifications:**● Union: CNA### ### ● Work Shift: Day Shift### ### ● FTE: 1.0### ### ● Scheduled Hours: 40*If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!*### About Salinas Valley HealthSalinas Valley Health, formerly Salinas Valley Memorial Hospital, founded in 1953, is the cornerstone of what would eventually become Salinas Valley Health. Today, we serve thousands of individuals and families just like you throughout the Salinas Valley, Monterey Peninsula and the surrounding region. Each year, our highly trained team of healthcare professionals takes our renowned quality of patient care to the next level. Our team actively utilizes the latest medical techniques with our state-of-the-art technology to improve your health and well-being. In many cases this provides you and your family the opportunity to receive specialized care right here in your own community, without the need for travel. Our 263-bed acute care medical center employs more than 2,036 people and has a medical staff of more than 300 board-certified physicians across a broad spectrum of specialties, all dedicated to your care.