Case Manager- In Office, RN
Company: Grandcare Health Services
Posted on: September 14, 2018
Job DescriptionJob Title: Case Manager, RN (Office)Grandcare Health Services is a certified winner, Great Places to Work- 2018!Reports to (Title): Administrator/Director of Patient Care Services. Must be willing to go to Orange County and Pasadena site visits with staff.Responsible for overseeing the field staff caseload. With focus on assisting the clinical staff with optimal clinical, financial and quality of life outcomes. Monitors information daily as appropriate including patient scheduled visits and staff productivity. Evaluates the services provided and outcomes achieved by the team and recommends enhancements and/or improvements for programs and staff development to ensure consistent cost effectiveness and compliance with all state and federal regulations and guidelines in day-to-day activities.Essential Duties and Responsibilities:
- Oversee, coordinate, and monitor field staff performance both clinical and non-clinical staff activities of assigned case load.
- Functions as hands-on supervisor for daily Case Management activities including medical necessity review, initial assessments, continued stay review, discharge planning, and other duties as required.
- Manages and evaluates team members in the performance of various case management activities.
- Maintains and manages a minimum of 50-60 cases per week.
- Performs and promotes interdepartmental integration and collaboration to enhance the continuity of care for all disciplines.
- Collaborates with the intake department to ensure adequate staffing, service levels, and customer satisfaction is provided.
- Monitor field staff productivity, quality indicators, and financial performance metric.
- Maintains effective team member relations in a collaborative manner.
- Assists with conducting regular monthly staff meetings.
- Assists with selection, orientation and mentoring of new team members.
- Participates in providing constructive feedback on field staff performance, through incoming calls from patient, families, referrals and medical providers.
- Participate in quality audit reviews for assigned case load.
- May conduct direct patient care field visits, in the event of a staffing shortage.· Implements and ensures self and team compliance with agency policies and procedures, Title 22, Medicare Conditions of Participation and The Joint Commission standards.Case Management· Communicates effectively and timely with physicians, and all disciplines assigned to the team regarding changes to the patient’s plan of care.· Responsible for planning, coordination and management of patient care plan for assigned caseload.· Monitors and reviews nursing assessment documentation within 48 hours.· Completes and maintains current: case conference summaries, physician orders, clinical communication, and medication profiles for assigned patients, as clinically indicated.· Conduct case conferences meeting for assigned case load. And ensure case conference summary documentation is completed.· Completes 30 day progress notes and 60 day/discharge summaries on assigned patients.· Coordinate the delivery of all equipment, medical supply, and resource management for assigned patients.· Serves as the direct contact and liaison between: patients/caregivers, physicians, referral sources, and payer sources for assigned patients.· Assigning and scheduling work activities for the field staff employees.
- Review medical records to assess medical necessity.
- Participate in the organization quality management program.
- Collaborate with multidisciplinary team to assess and improve and clinical outcomes/ documentation compliance.· Flexibility to work evenings and/or weekends when necessary.· Participation in the on-call rotation for afterhours, holiday and weekend coverage.· Participate in other duties that may be assigned by the administrator, and/or organization’s executive leadership.Education· Participates with community education activities.· Participates with education and training of new and existing employees as assigned by the Director of Nursing or Designee and/or Nursing Supervisor.· Participate in ongoing educational in-services.Qualifications/Requirements:EDUCATION:· Graduate of an accredited school of professional nursing. BSN and PHN preferred.CONTINUING EDUCATION REQUIREMENTSAgency personnel are expected to participate in appropriate continuing education as may be requested by their immediate supervisor. In addition, agency personnel are expected to accept personal responsibility for other educational activities to enhance job related skills and abilities. All agency personnel must attend mandatory educational programs.EXPERIENCE/EQUIVALENT TO:· 2+ years of professional nursing experience within the last 5 years preferred.· Knowledge of OASIS, CMS 485, Title 22, Medicare Conditions of Participation and The Joint Commission standards preferred.· Experience in Case Management/ Utilization review preferredLicenses/Certifications:· Current license as a Registered Nurse in the State of California. Required.· IV Certification with proficiency in venipuncture and administration of IV fluids and medications through all vascular access preferred.· CPR/BLS certification. Required· Current driver’s license, good driving record, and reliable transportation Company DescriptionGrandCare Health Services has been a recognized leader in the provision of home care services in Southern California for over a decade. GrandCare Health Services is based in Pasadena with satellite branches in Torrance and San Diego. Grandcare Health Services works to provide our field staff the best support possible to enable our field staff to provide our clients with the best care possible in the comfort of their home. Grandcare Health Services is licensed by the Department of Health Services of California.
Keywords: Grandcare Health Services, Pasadena , Case Manager- In Office, RN, Healthcare , Pasadena, California
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