Lead Case Manager Full Time Days

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Day

• 10 Hour (United States of America)

Job Summary

Oversees the daily flow of Utilization Review and Discharge Planning on all the Nursing Units, including the Emergency Department and CTI Team. Assures the team is appropriately assessing patient need for admission, is assigning patients to the appropriate level of care, is giving adequate resources for post-discharge care, is providing adequate clinical information to insurances, and is obtaining authorization for services by payers.

Essential Functions

The essential functions listed below are general examples and not a description of comprehensive duties. Specific duties and responsibilities may vary depending on department or program needs without changing nature or scope of this position or level of responsibility. May be asked to perform other duties as assigned.

• Provides leadership and direction in accordance with the hospital's guidelines and consistent with nursing and program goals and objectives.

• Oversee daily flow of Utilization Review and Discharge Planning by the Case Managers, Social Workers and Discharge Planning Assistants. Also oversees the daily workflow of the CTI Team.

• Recruits, interviews and selects nursing staff. Provides onboarding and continued training of staff to orient on case management policy and process

• Continuously mentors, counsels, trains and facilitates goal setting of staff through performance development program.

• Reviews Readmissions and High-Risk Patients who may be a potential Readmission and be sure staff is doing focused discharge planning of these.

• Works collaboratively as a member of a multidisciplinary healthcare team across the continuum to plan and monitor patient's care for health management plan, social needs, goals of care and family support, appropriate level of care, utilization of acute care services and length of stay.

• Educates patients and family/caregiver about relevant community resources.

• Provides post discharge coordination of care. Act as a liaison/coordinator with post-acute services monitoring progress of care and facilitating transition to next level of care and ensuring warm hand-off. Collaborates with patient and family to set up Physician follow up visit within 7 days of acute care discharge to home.

• Collaborates with the Director in maintenance of the therapeutic environment. Coordinates resources for optimal clinical and financial outcomes

• Works with community services on other programs to support the projects targeted population

• Function as a resource nurse for staff as needed

• Continuously assess work environment and processes to identify risks and escalates as appropriate

• Employee must perform all duties and responsibilities in accordance with the C-I-CARE Standards of the Hospital. C-I-CARE is the foundation of Stanford Healthcare

• ValleyCare's patient-experience and represents a framework for patient-centered interactions

Job Qualifications

Education

• Graduate from an accredited school of nursing

Experience

• Five years of recent Acute Care Management/Utilization Review experience

• Management Experience preferred

License/ Certifications

• Current CA RN License
• BLS - Basic Life Support from the American Heart Association.
• ACM or CCM preferred

Knowledge, Skills, and Abilities

• Ability to work independently and function effectively as a member of an interdisciplinary team.

• Basic Computer skills required.

• Strong communication and interpersonal skills

• Strong advocacy and problem-solving skills

• Strong attention to detail

• Knowledge of the principles of growth and development and the ability to assess and interpret data regarding a patient's status to identify the patient's needs and appropriate care

• Knowledge of acute care in relation to safety, security and joint commission standards

• Ability to manage prolonged walking, sitting, standing and phone use

Physical Demand and Working Conditions

The Physical Requirements and Working Conditions in which the job is typically performed are available from the Occupational Health Department. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job.

Equal Opportunity Employer

Equal Opportunity Employer Stanford Health Care

• ValleyCare (SHC

• VC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Base Pay Scale: Generally starting at $64.00 - $87.00 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.