Case Manager II
Company: Kindred Hospital Paramount
Location: Paramount
Posted on: May 26, 2023
Job Description:
Description
At Kindred It Starts With Me. Our commitment is to deliver
excellence and an empathetic human experience to every patient,
every family member, every employee, every time. We do this through
our Core Values which help in guiding our work every day.Job
Summary: The Case Manager II 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,
community resources, 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 and family's ability to make
informed decisions. Demonstrates knowledge of the principles of
growth and development over the life span and the skills necessary
to provide age appropriate care to the patient population
served.Participates in interdisciplinary patient care rounds and/or
conferences to review treatment goals, optimize resource
utilization, provide family education and identified post hospital
needs. Collaborates with clinical staff 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.Discharge
Planning
Conducts comprehensive, ongoing
assessment of patients - to provide timely and safe discharge
planning. Provide comprehensive discharge planning for each
patient. Utilizes critical thinking to develop and execute
effective discharge planning. Coordinates and communicates with
patient/family efficiently and effectively. Utilization Management
Conducts medical necessity review for
appropriate utilization of services from admission through
discharge. Promotes effective and efficient utilization of clinical
resources.Conducts timely and accurate clinical reviews, care
collaboration and coordination of continued stay authorization with
payor.Qualifications
Education: Graduate of an accredited program required:
RN, BSN preferred OR
Master of Social Work with licensure
as required by state regulations; OR - - - - - - - - - - - -
Bachelor of Social Work with
licensure as required by state regulationsLicenses/Certification:
Healthcare professional licensure
required as Registered Nurse or Licensed Clinical Social Worker
(LCSW) or Licensed Social Worker (LSW) if required by state
regulations.Certification in Case Management preferred.Experience:
Two years of experience in healthcare
setting preferred.Prefer prior experience in case management,
utilization review, or discharge
planning.Knowledge/Skills/Abilities/Expectations:
Knowledge of government and
non-government payor practices, regulations, standards and
reimbursement.Knowledge of Medicare benefits and insurance
processes and contracts.Knowledge of accreditation standards and
compliance requirements.
Keywords: Kindred Hospital Paramount, Paramount , Case Manager II, Executive , Paramount, California
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