Pediatric ED Care Navigator

LE0010 Stanford Health Care; Palo Alto (CA); On-site; USD 126,000 - 168,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Educational assistance

Wellness program

Job summary

Stanford Health Care, a leader in patient-centered care, is seeking a Complex Care Manager with a Master’s in Social Work and an active LCSW license. You will advocate for patients and families, coordinate care across disciplines, and lead education initiatives for staff and community partners.

The role emphasizes evidence-based practice and compliance within a multidisciplinary health care team. You will operate within Stanford Health Care’s standards, helping patients navigate care plans,

Qualifications

• Master’s degree in Social Work from an accredited college or university.
• Three (3) years of progressively responsible and directly related work experience.
• Knowledge of contemporary case management principles and practice methods, including assessment, treatment planning, utilization management, and quality assurance.
• Ability to use multiple electronic systems, software programs, and the internet to review and record information.
• Knowledge of medical terminology and related levels of care and treatment.
• Ability to collaborate across disciplines to provide comprehensive, integrated care.
• Ability to develop and implement educational materials and presentations for all levels of learners.
• Ability to develop appropriate treatment plans, communicates with interdisciplinary teams, and coordinates care.
• Ability to monitor and assure the patient's access to the appropriate level of care; the right health care providers; and the correct setting and services to meet the patient's needs; promote coordination and continuity in patient health care.

Responsibilities

• Advocacy & Education: Patient/Family Self Care Management
• Patient/Family Health Management Education
• Bioethics Referrals & Management
• Physician, Staff & Community Education
• Case Management Education & Training
• Risk Management Identification & Referral
• Clinical Care Coordination/Facilitation: Plan of Care & Outcomes Management
• Patient Care Integration
• Resource Management
• Patient/Family Care Conferences
• Interdisciplinary Care Communication/Coordination
• Continuity of Care Planning Management
• Continuity/Transition Management: Capacity/Access Management & Throughput
• Discharge Planning
• SNF/Rehab/LTAC/Assisted Living Placement
• Board and Care/Attendant Care Placement
• Transportation & Travel Arrangements
• DME
• Home Health/Home Infusion
• Mental Health Service Coordination
• Hospice Dialysis Coordination & Arrangements
• Pharmaceutical Authorization/Management
• Community Resource Coordination
• Advance Directives
• Palliative/End-of-Life Care
• Health Care Resource Management/ Clinical Cost Efficiency
• Financial Assistance/Referrals
• Appeals Management
• Entitlement Program Coordination
• Patient Benefits Coordination: CCS/GHPP/Medicare/Medi-Cal/SSI
• Performance & Outcomes Management: Federal/State/Local Regulatory Agency Compliance
• Joint Commission Standards Compliance
• Clinical Documentation Education/Support
• Clinical Guidelines/Pathways/Evidenced Based Practice
• Organizational Financial Performance/Management
• Length of Stay, Cost per Case, Denial Management
• Psychosocial Management: Crisis Intervention
• Psychosocial Assessment/Functioning
• Counseling Support & Referral
• Abuse/Neglect Identification & Referral (Partner, Child, Elder)
• Family Issues Affecting Care
• Coping/Emotional Adjustment
• Grief/Bereavement Support (Individual & Group)
• Adoption Resources
• Health/Wellness Promotion
• Substance Abuse Screening/Resources
• Psychiatric Screening/Behavior
• Management, Staff Support and Crisis Intervention (Critical Incident Stress Debriefing)
• Research & Practice Development: Clinical Practice Improvements
• Evidenced Based Clinical Practice
• Social Work Best Practice Standards Development
• Social Work Competency Development
• Case Management Best Practice Standards Development
• Case Management Competency Development
• Utilization Management: Avoidable Delay Identification
• Intervention & Tracking
• Utilization Review
• Medical Necessity Review
• Care Plan Progression
• Pre-Admission Planning
• Third Party Payer Communication
• Level of Care Appropriateness Coordination
• Admission Status Determination
• Clinical Denial Prevention Education
• LCSW - Lic Clinical Social Worker

Skills

Interdisciplinary collaboration

Medical terminology

Educational materials

Patient care coordination

Education

Master’s degree in Social Work

LCSW certification

Tools

Electronic health records

Job description

Stanford Health Care, a leader in patient-centered care, is seeking a Complex Care Manager with a Master’s in Social Work and an active LCSW license. You will advocate for patients and families, coordinate care across disciplines, and lead education initiatives for staff and community partners.

The role emphasizes evidence-based practice and compliance within a multidisciplinary health care team. You will operate within Stanford Health Care’s standards, helping patients navigate care plans,