Case Manager II PRN/Day

Socket.dev; West Covina (CA); On-site; USD 65,000 - 83,000; Full time

Job summary

Kindred Hospital San Gabriel Valley in West Covina, CA, is seeking a Care Coordination Specialist to support the Interdisciplinary Care Transitions team. You will coordinate care across physicians, patients, families, and post-acute providers to ensure smooth transitions and optimal resource use.

The role requires RN licensure in California and 2+ years in healthcare, with strong communication, critical thinking, and knowledge of payor practices.

Qualifications

• Registered nursing licensure required.
• Bachelor's in nursing or social work preferred.
• Experience in case management or discharge planning preferred.
• Excellent communication and teamwork skills.

Responsibilities

• Coordinate care with the Interdisciplinary Team and physicians.
• Monitor patient stay for effective care coordination.
• Advise on utilization review and discharge planning.
• Advocate for patients and families during care transitions.
• Collaborate during rounds to optimize resource use.

Skills

Payor practices

Medicare benefits

Accreditation standards

Critical thinking

Microsoft Office

Interpersonal skills

Travel 0-25%

Fluent English

Education

RN licensure

BSN/MSN/BSW/MSW preferred

Job description

Kindred Hospital San Gabriel Valley is a 76-bed long-term acute care hospital offering the same in-depth care you would receive in a traditional hospital, but for an extended recovery period. We partner with your physician and offer 24-hour clinical care seven days a week so you can start your journey to wellness. We are located just over 2 miles outside of downtown West Covina, and right down the street from Covina Square Shopping Center.

Job Summary

Coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs. Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.

Essential Functions

Care Coordination

• Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
• Monitors all areas of patients' stay for effective care coordination and efficient care facilitation.
• Remains current from a knowledge base perspective regarding reimbursement modalities, communityresources, case management, psychosocial and legal issues that affect patients and providers of care.
• Appropriately refers high risk patients who would benefit from additional support.
• Serves as a patient advocate. Enhances a collaborative relationship to maximize the patient's andfamily's ability to make informed decisions.
• Demonstrates knowledge of the principles of growth and development over the life span and the skillsnecessary to provide age appropriate care to the patient population served.
• Participates in interdisciplinary patient care rounds and/or conferences to review treatment goals, optimizeresource utilization, provide family education and identified post hospital needs. Collaborates with clinicalstaff in the development and execution of the plan of care, and achievement of goals.
• Coordinates with interdisciplinary care team, physicians, patients, families, post-acute providers, payors,and others in the planning of the patients' care throughout the care continuum.

Knowledge/Skills/Abilities/Expectations

• Knowledge of government and non-government payor practices, regulations, standards andreimbursement.
• Knowledge of Medicare benefits and insurance processes and contracts.
• Knowledge of accreditation standards and compliance requirements.
• Ability to demonstrate critical thinking, appropriate prioritization and time management skills.
• Basic computer skills with working knowledge of Microsoft Office, word-processing and spreadsheetsoftware.
• Excellent interpersonal, verbal and written skills in order to communicate effectively and to obtaincooperation/collaboration from hospital leadership, as well as physicians, payors and otherexternalcustomers
• Demonstrates good interpersonal skills when working or interacting with patients, their families and otherstaff members.
• Approximate percent of time required to travel, 0%25
• Must read, write and speak fluent English.
• Must have good and regular attendance.
• Performs other related duties as assigned.

Pay Range: $47.26-$59.93/hr.

ScionHealth has a comprehensive benefits package for benefit-eligible employees that includes Medical, Dental, Vision, 401(k), FSA/HSA, Life Insurance, Paid Time Off, and Wellness.

Education

• Postsecondary (Cert/Diploma/Program Grad) from an accredited school of nursing (Required) And
• Bachelor's Degree in nursing or social work: BSN, MSN, BSW or MSW (Preferred)

Licenses/Certifications

• RN - Registered Nurse - State Licensure and/or Compact State Licensure in the state of practice Upon Hire (Required) Or
• LCSW- License Clinical Social Worker LCSW or LSW Upon Hire (Required) Or
• CSWCM - Social Work Case Manager Certification Upon Hire (Preferred)

Experience

• 2+ years experience in healthcare setting (Required) And
• Prior Experience in case management, utilization review, or discharge planning (Preferred)