Clinical Case Manager (Rn-Lcsw-Lmft - Sharp Mesa Vista - Per Diem - Days

Hours:

Shift Start Time:

Variable

Shift End Time:

Variable

AWS Hours Requirement:

8/40 - 8 Hour Shift

Additional Shift Information:

starts between 6:30 and 8:30am (remote not offered)

Weekend Requirements:

No Weekends

On-Call Required:

No

Hourly Pay Range (Minimum

• Midpoint

• Maximum):

$55.673 - $71.836 - $87.999

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

Perform admission and concurrent review of patients, based upon needs regardless of payor sources. Identifies patients (as early as possible in the admission) requiring discharge planning. Determines admission necessity based upon severity of illness and intensity of service criteria. Ensures a multi-disciplinary approach in planning of care across the continuum. Summary: Through assessment and planning ensures that patients are placed in the appropriate setting and receiving the appropriate care in a timely manner.

Required Qualifications

• Education pursuant to licensure requirement.

• Background and educational experience which will establish credibility with physicians and non-physician health care practitioners involved in Admission & Triage, Discharge planning, and case management of chemical dependency patients.

• AHA Basic Life Support for Healthcare Professional (AHA BLS Healthcare) - American Heart Association

• REQUIRED

• California Registered Nurse (RN) - CA Board of Registered Nursing OR California BBS Licensed Clinical Social Worker (LCSW) - CA Board of Behavioral Sciences OR California BBS Licensed Marriage and Family Therapist (LMFT) - CA Board of Behavioral Sciences

• REQUIRED

Preferred Qualifications

• Referral development experience.

Essential Functions

• Admission review

Patients within assigned case loads will continually be monitored for changes in status and situation in order to make effective discharge plans.

UR documentation in IDX is completed by end of working day.

• Clinical resource

Identifies patient risk factors/status, and monitors and evaluates short and long-term patient responses to therapeutic interventions.

Develops, implements and evaluates educational opportunities/programs for patients/family and staff to promote effective inpatient and post-acute discharge outcomes.

Coordinates and collaborates on at least two quality/cost containment project every year.

• Collaboration

Works collaboratively with social workers, home health liaisons, case managers and patient financial services to effectively manage length of stay, patient care, discharge and home planning process for patients and families.

• Confidentiality

Maintains confidentiality of all patient, hospital or physician-related information.

Updates and maintains clinical skills related to different age groups. Obtains education regarding issues such as diagnosis, treatment plans, developmental issues, cultural issues, life adjustments age specific concerns, and interventions for target populations.

Departmental paperwork regarding patients remains in the office when not in use.

Is knowledgeable of current laws and regulations regarding Utilization Review and Discharge Planning.

Morning arrival time insures orderly transfer of cases between workers, allowing for discussion of high risk case and enough time set aside to update paperwork and arrive at unit rounds on time.

• Data collection

Participates in data and statistics collection as requested by Utilization Review, Service Line and Quality Improvement Committees.

• Denial and appeal process

Participates in the UR denial and appeal process.

• Department improvement

Wears appropriate protective equipment when necessary. Identifies, reports and follows through on potential hazards for patients, visitors and employees.

Responds to age specific needs of the population served.

Demonstrates the knowledge and skills necessary to provide care or service based on physical, psychosocial, educational, safety and related criteria appropriate to the age of the patients served in assigned caseload.

• Discharge planning

Referrals are responded to within 24 hours of receipt.

Assists with referrals to community resources.

Arranges for home care needs as delineated by agreement with Home Health Liaison.

The needs and desires of the patient and family will be considered when making discharge plans. Facilitates appropriate placement with patient/family, physician, and payor input. Reevaluates patient as necessary, according to UR and Discharge Planning needs.

Participates in patient care conferences.

Ongoing contact and documentation of that contact is made in the medical record and on departmental paperwork. Documentation is timely, appropriate, clear, concise and reflects what is going on in the case. Notes are dated and timed.

The final disposition of each case is noted within the chart and on departmental paperwork before the end of that working day.

Late entries into the medical record are identified as such and the reason for the delay in charting is evident within the body of the note.

All information on each patient will be up-to-date. Departmental notes and paperwork will be clear and indicate status of the case.

• Financial resource

Contacts Financial Consultant to assist patients and families as needed.

Communicates with admitting physician regarding patient stay; consults with Physician Advisor, as necessary, regarding specific patients.

Interfaces with Business Office regarding ongoing certification of stay.

Provides concurrent and retro UR reviews to Review Organizations.

Identifies reasons for delay in service and or lack of Severity of Illness / Intensity of Service.

• Patient care

Screens all patients included in case load that have been admitted to the hospital within 24 hours of admission or first working day.

Screening of the identified high risk will include identification of patient's discharge planning needs and documentation there of.

Attendance at unit rounds is mandatory.

Assessments are done daily throughout stay through interviews with patient and/or family, in addition to information gathered through rounds, consultation with nursing, physicians, social services, other clinical staff members and the medical record.

Coordinates discharge plan of care with patient/family and health care team.

Knowledge, Skills, and Abilities

• Ability to maintain strict confidentiality, knowledge of medical terminology, treatment plans, health care delivery systems, severity of illness and intensity of treatment criteria.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class